Paracoccidioidomycosis may involve the larynx and can be mistaken for laryngeal carcinoma. It is important to diagnose this correctly since radical surgery is unnecessary.
Clinical features:
(1) adult with history of living or visiting a region endemic for paracoccidioidomycosis
(2) hoarseness
(3) exophytic or ulcerative lesion of the larynx with or without involvement of the vocal cords
(4) variable cervical lymphadenopathy
(5) biopsy of the lesion showing (a) the presence of granulomatous inflammation with fungi and (b) absence of malignancy
Sources of error associated with misdiagnosis:
(1) The patient is a long-time smoker.
(2) Overinterpretation of reactive atypia in a biopsy or brushing as representing malignancy.
(3) Failure to identify exposure history.
(4) Living in a region where paracoccidioidomycosis is not a consideration.
To read more or access our algorithms and calculators, please log in or register.
