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77th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

24.05. - 28.05.2006, Mannheim

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

Meeting Abstract

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  • corresponding author presenting/speaker Susanne Kinzer - Department of Otorhinolaryngology, Head an Neck Surgery, University of Freiburg, Freiburg, Germany
  • author Carsten C Boedeker - Department of Otorhinolaryngology, Head an Neck Surgery, University of Freiburg, Freiburg, Germany
  • author Gerd J Ridder - Department of Otorhinolaryngology, Head an Neck Surgery, University of Freiburg, Freiburg, Germany

German Society of Otorhinolaryngology, Head and Neck Surgery. 77th Annual Meeting of the German Society of Otorhinolaryngology, Head and Neck Surgery. Mannheim, 24.-28.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06hno067

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2006/06hno067.shtml

Published: September 7, 2006

© 2006 Kinzer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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.