Laryngeal Mass

Abstract

A 55 years old male, a chronic smoker and a known diabetic was presented to the outpatient department, Sultan Qaboos University Hospital with complaints of change in voice, difficulty in swallowing and breathing for one month duration. The patient had minimal inspiratory stridor and flexible laryngoscopy showed a slough covered proliferative growth involving both surface of epiglottis and false cords. The vocal cords were mobile. The laryngeal crepitus was present and no neck nodes were clinically palpable. The patient denied any history of fever or weight loss. His total leukocyte count was normal; ESR was raised 48 mm 1st hour. The chest X-ray was normal and CT scan of the neck showed a contrast enhancing destructive lesion involving both surfaces of epiglottis and false cords. The patient was taken up for direct laryngoscopy and biopsy under general anaesthesia. There was minimal bleeding during the biopsy and there were no postoperative complications. The histopathology showed features of epitheloid granuloma, caseating necrosis surrounded by Langhans giant cells. The AFB stain and PAS stain for fungi were negative. Three specimens of sputum for acid fast bacilli were negative but the Monteux test was positive 15X15 mm.