A Case of Actinomycosis in the Neck Suspected as Hypopharyngeal Carcinoma

Abstract

Actinomycosis is an unusual inflammatory disease caused primarily by Actinomyces israelii. The disease commonly appears as a chronic granulomatous lesion resembling a tumor on the head or neck, so it has been often difficult to distinguish the lesion from a malignant tumor. In this paper, a case of actinomycosis of the neck suspected as hypopharyngeal carcinoma was reported. An 87-year-old man, who was a dialysis patient, visited our hospital with left neck mass.

We suspected hypopharyngeal carcinoma and lymph node metastasis from a study of the CT scan. However, by using both microscopic examination and culture inspection, it was revealed that the patient’s neck abscess was a typical case of actinomycosis. We resected the neck mass under general anesthesia, and made a diagnosis of actinomycosis. It was estimated that the hypopharyngeal lesion was an inflammatory reaction to the abscess. After surgery, we prescribed clarithromycin (CAM) for 8 weeks, and the patient has been shown no sign of recurrence.