An Incidental Nasopharyngeal Carcinoma Coexistent with Primary Nasopharyngeal Tuberculosis

Objective:       To describe a case of nasopharyngeal carcinoma coexistent with primary nasopharyngeal tuberculosis and review the literature. Methods:             Design:  Case Report             Setting: Tertiary Public University Hospital             Patient: One Results:  A 28-year-old man presented with recurrent sore throat and neck pain with clinically enlarged tonsils. He underwent a routine adenotonsilectomy. Histopathologic examination revealed non-keratinizing squamous cell carcinoma with caseating granulomatous inflammation typical for tuberculosis in the same adenoid specimen. Nasopharyngeal carcinoma was staged T2bN2M0. He was treated with concurrent chemoradiotherapy and a 9-month course of anti tuberculosis treatment. He recovered and remained symptom free 1 year after treatment. Conclusion:    Nasopharyngeal carcinoma (NPC) and tuberculosis (TB) are both very common diseases in Sabah, East Malaysia. However, it is very rare that both diseases present at the same time and same anatomical area in a patient. Diagnosis can be very challenging and confusing. Multidisciplinary consultations are warranted for appropriate treatment. Combined anti-tuberculosis treatment and concurrent chemoradiotherapy may be appropriate and effective.   Keywords:  Nasopharyngeal carcinoma, Primary Nasopharyngeal Tuberculosis, adenotonsillectomy