%0 Journal Article %T Vocal Cord Actinomycosis Mimicking a Laryngeal Tumor %A Keisuke Yoshihama %A Yasumasa Kato %A Yuh Baba %J Case Reports in Otolaryngology %D 2013 %I Hindawi Publishing Corporation %R 10.1155/2013/361986 %X Laryngeal carcinoma and laryngeal papilloma are the most commonly encountered tumorous lesions in the larynx. Herein, we report a case of the mass arising from the left vocal cord in a 49-year-old Japanese man. Endoscopic examination suggested that the mass is a tumor such as carcinoma and papilloma. Pathological examination showed that the specimen demonstrated actinomycosis in the left vocal cord. Although vocal cord actinomycosis is extremely rare, the otolaryngologist should recognize this condition during the inspection of the larynx. 1. Introduction Laryngeal carcinoma and laryngeal papilloma are the most commonly encountered tumorous lesions in the larynx. Actinomycosis is a disease that is mainly caused by Actinomyces israelii. Actinomyces israelii is an anaerobic, Gram-positive organism that is normally present in the oral cavity. Clinical manifestation mainly occurs in one of three forms: cervicofacial, abdominal-pelvic, or pulmonary actinomycosis. However, the actinomycosis of the larynx is very rare. Here, we report a case of primary vocal cord actinomycosis mimicking a laryngeal tumor. 2. Case Report Approximately one year ago, a 49-year-old Japanese man came for treatment with the complaint of his hoarseness of voice for 2 years. He had no fever, odynophagia, weight loss, or dysphagia. There was no history of any operation in head and neck, and he had diabetes mellitus and dental caries. Laryngoscopy showed a mass of surface irregularity in the anterior one-third part of the left vocal cord (Figure 1). The rest of larynx and hypopharynx were normal. Examination of the neck revealed no lymphadenopathy. Laboratory investigation including complete hemogram, erythrocyte sedimentation rate, renal function tests, and liver function tests was within normal limits. The value of HbA1c was 6.1. Serological tests for HIV, HbsAg, and HCV RNA were negative. His chest roentgenogram was normal. The patient underwent direct laryngoscopy, and the mass was excised from the left vocal cord. In histopathological examination, the biopsy material revealed actinomycosis with vocal nodule (Figure 2). An infectious disease consultation was obtained, and the patient started treatment with amoxicillin-clavulanate 625£¿mg orally three times a day for 8 weeks. During the 2 months of treatment, the vocal cords and other laryngeal structures were observed to be normal. Figure 1: A mass of surface irregularity in the anterior one-third part of the left vocal cord. Figure 2: Microscopically, specimen demonstrated vocal cord actinomycosis (hematoxylin and eosin). 3. %U http://www.hindawi.com/journals/criot/2013/361986/