A Case Series of Extranodal Tuberculosis of Head and Neck, Tunisia

Background: Tuberculosis is a chronic specific infectious disease caused by mycobacteria: Koch bacillus (BK). Despite a re-increase in the incidence of tuberculosis, extra-nodal location on the head and neck remains rare. Clinical symptomatology is non-specific and even data from paraclinical explorations often pose the problem of differential diagnosis with tumor pathology.

Methods: We report a series of 29 cases of extranodal tuberculosis collected over a period of 32 years [1986-2018] in the ENT department of the military hospital of Tunis. Epidemiological factors, clinical condition at presentation, biological and radiologic explorations undergone according to each location, methods of biopsy, treatment modalities, follow-up, and outcome were reported.

Results: Rhinosinusopharyngeal involvement was predominant (45%) followed by glandular involvement (14%). Laryngeal tuberculosis is relatively rare, representing almost 1% of the extra-pulmonary locations of the disease. The diagnosis was histopathological in most cases. Concomitant pulmonary tuberculosis was detected in two cases and spinal lumbar in one case. Treatment was medical in all cases.

Conclusion: The clinical presentation of extranodal tuberculosis is various and non-specific. Neoplastic pathology is the main differential diagnosis. However, diagnosis should be systematically raised in endemic countries.