Abstract
Actinomycosis is an infectious disease typically caused by Actinomyces israelii. It follows a chronic and granulomatous process and is often confused with neoplasms. We herein describe a case of actinomycosis of the lingual tonsil that was originally considered to be oropharyngeal carcinoma. An 82-year-old male with a history of laryngeal carcinoma had right cervical swelling without pain. Laryngoscopy revealed a mass at the right lingual tonsil. Ultrasonography showed a right cervical lymphadenopathy. Magnetic resonance imaging showed the tumor mass in the right lingeal tonsil and the right cervical lymphadenopathy. FDG-PET/CT revealed a high metabolic activity of the tumor mass and the right lymphadenopathy. Biopsies were performed under local anesthesia three times over the course of a month, but no malignant tissue was found in any specimen. We performed these biopsies from the depths of the right lingual tonsil under general anesthesia. The histopathological examination showed evidence of actinomycosis. Postoperative penicillin therapy for six months completely cured the patient of this very rare case of actinomycosis. This case suggests that actinomycosis should be considered in the differential diagnosis of cervicofacial masses when the biopsy is negative for carcinoma.
