Artikel
Deep neck abscess masquerading malignant neoplasms - experiences and clinical management
Der Halsabszess als Primärmanifestation von Kopf- und Halskarzinomen – Erfahrungen und Konsequenzen für das diagnostische Handeln
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Autoren
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Susanne Kinzer
- Department of Otorhinolaryngology, Head an Neck Surgery, University of Freiburg, Freiburg, Germany
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Carsten C Boedeker
- Department of Otorhinolaryngology, Head an Neck Surgery, University of Freiburg, Freiburg, Germany
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Gerd J Ridder
- Department of Otorhinolaryngology, Head an Neck Surgery, University of Freiburg, Freiburg, Germany
| Veröffentlicht: | 7. September 2006 |
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Gliederung
Text
Neck abscesses and deep neck space infections are common diseases in the field of otolaryngology. First manifestations of carcinomas or malignant lymph node metastases as neck abscesses are rather uncommon.
A retrospective study between 1997 and 2005 was conducted including 234 patients with deep neck space infections. Peritonsillar, salivary gland as well as dentogen abscesses and abscesses of traumatic origin were excluded.
In 13 patients (5.6%), the deep neck space infection was the first manifestation of a malignant tumour. The average age in this group of patients was 58 years (minimum 43, maximum 89 years). There were 11 male and 2 female patients.
In 6 cases, histopathologic investigations revealed a squamous cell carcinoma of the oro- and hypopharynx and in 2 cases of the larynx, respectively. In 2 cases, a lymph node metastasis of a head and neck carcinoma was found. Another 2 abscesses were the first manifestation of a carcinoma of unknown primary. One abscess revealed characteristics of a non-Hodgkin-lymphoma.
In 4 patients, we detected aerobic and in 2 patients anaerobic causative organisms. Two of the positive cultures turned out to be polymicrobial with a mixed aerobic-anaerobic flora. In 4 patients, the culture remained sterile.
Our study demonstrates the importance to consider malignant head and neck neoplasms in patients with deep neck space abscesses, especially if there are typical risk factors for squamous cell carcinomas. We recommend taking a biopsy specimen of the abscess wall to establish or exclude the diagnosis of a malignant tumour.
