Abstract

Laryngeal cancer is rising in incidence among elderly men with history of smoking. Laryngeal tuberculosis is a rare clinical entity and the incidence is significantly less than 1% of all tuberculosis. This case report highlights the co-existence of laryngeal cancer and TB in a 75-year-old man who presented to us with a 4-year history of hoarseness. Flexible laryngoscopy revealed a mass at right false cord extending to left false cord. First biopsy showed severe dysplasia and was suggested for deeper biopsy. A second biopsy taken after a delay confirmed moderately-differentiated squamous cell carcinoma with evidence of laryngeal tuberculosis. The tumour was already more extensive from initial staging of T2N1M0 to a T4N1M0 transglottic tumour. Patient was given options of initiation of anti-tubercular drugs and radiotherapy, or a plan for total laryngectomy after stabilizing on anti-tubercular drugs. However, patient was undecided, which has led to the tumour being more extensive. Patient was started on anti-tubercular drugs for approximately 6 months and subsequently deteriorated. Patient was not fit for any chemo or radiotherapy. Based on this case report, it is shown that TB and malignancy can occur synchronously at the same anatomical location and the importance of early diagnosis and treatment need to be highlighted.

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