Invasive Epiglottic Aspergillosis Mimicking Supraglottic Laryngeal Carcinoma—A Case Report and Review of the Literature

Abstract

Background: Invasive laryngeal aspergillosis is an uncommon disorder. The presentation can be misleading, mimicking other laryngeal disorders, specifically laryngeal cancer. The isolated involvement of the larynx is even more unusual making the diagnosis even more challenging. Case report: We describe the case of a 66-year-old man with diabetes who presented with a sore throat, low grade fever, dysphagia, and odynophagia of 3 days duration. He was initially diagnosed as having a supraglottic laryngeal cancer with involvement and paralysis of the left vocal cord. However, further histopathologic examination revealed the presence of an invasive epiglottic aspergillosis with no evidence of malignancy. He was treated with surgical debridement and voriconazole for 3 weeks and responded well to therapy with full recovery. Conclusion: In the presence of laryngeal ulcerative and/or granulomatous lesions, the possibility of invasive fungal laryngitis (aspergillosis specifically), although improbable, should always be kept in mind especially in the presence of predisposing conditions. Starting empiric antifungal therapy is integral when the disease is suspected but therapy is often delayed until pathologic confirmation is obtained. Prognosis is usually poor and will depend on the immune status of the patient.