Tonsillar tuberculosis mimicking tonsillar carcinoma: A case report

Abstract

Introduction: Extrapulmonary tuberculosis is rare even in endemic areas, and is dominated by lymph node involvement. Tonsillar tuberculosis is exceptional. The clinical examination and radiological explorations are non-specific.

Case presentation: A 45-year-old woman presented with chronic odynophagia and otalgia. Examination revealed an enlarged left palatine tonsil with an irregular surface and a firm consistency. Radiologic exploration was not specific. The patient underwent a tonsillar biopsy. Histopathology was consistent with tuberculosis and the patient was put on antitubercular drugs.

Clinical discussion: Tuberculosis is a global public health problem. Extrapulmonary tuberculosis is rare and mainly affects lymph nodes. Tonsillar tuberculosis is frequentely seen in individuals with immunodeficiency. Clinical features and imaging findings are non-specific. Diagnosis is based on histopathological and microbiological findings to rule out differential diagnoses especially cancer. Treatment is based on anti-tuberculosis drugs.

Conclusion: Our case illustrates a rare presentation of primary tuberculosis and highlights the importance of considering tuberculosis as a potential cause of tonsillitis.

Keywords: Case report; Extra pulmonary tuberculosis; Tonsillar carcinoma; Tonsils.

Fig. 1

A (Above) tonsillar asymmetry (black arrow) B (Below) MRI showed an enlarged left palatine tonsil with discrete T2 hypersignal, heterogeneous enhancement after contrast injection.