Wegener's granuloma localized in the larynx which was difficult to diagnose: Report of a case

Abstract

A patient had experienced intractable pharyngeal pain for several years. A macroscopic examination revealed that there was swelling and edema in the epiglottis and an arytenoid region, but no addition lesion was found. The lesion was suspected to be Wegener's granuloma because it was granulomatous and the patient's data indicated elevated levels of C-ANCA, although there were no typical pathological signs. Steroid therapy was initiated as diagnostic therapy and it was very effective. Wegener's granuloma is a systemic auto-immune disease which is characterized by a necrotizing granuloma of the upper or lower respiratory tract and generalized necrotizing vasculitis involving the arteries and veins. Many of the symptoms occur in the otorhinolaryngologic region, especially in thenasal region. Patients occasionally develop diverse upper tract symptoms or symptoms of other organs. So, it is often difficult to diagnose. This time, however, it was immediately suspected. A patient presented a very unusual case of Wegener's granuloma localized in the larynx. The symptoms were easily resolved by early therapy.