Tuberculosis of the head and neck: a review of 20 cases

Tuberculosis (TB) of the head and neck is currently a reemerging infectious disease and may be a diagnostic challenge for dental care providers. The aim of the present study was to retrospectively review the clinical features of patients diagnosed with TB of the head and neck during the past 16 years.

Thirteen male and 7 female patients with TB of the head and neck were histologically identified following surgical biopsy in our department between 1991 and 2007. The medical charts were reviewed.

The age distribution was broad, with 11 patients (55%) older than 50 years and 4 (20%) younger than 10 years old. Thirteen patients had oral lesions and 2 had multiple lesions. The most common oral location was the buccal mucosa and/or vestibule (5 cases), followed by the alveolar mucosa (4 cases), palate (2 cases), lip (2 cases), and tongue (1 case). Seven patients had cervical TB. The predominant clinical manifestation was ulceration. Two patients were found to have coexistent metastatic squamous cell carcinoma. Four patients were identified with active pulmonary lesions and 1 patient with evidence of old pulmonary TB on the 14 chest radiographs available.

Tuberculosis of the head and neck may not be as rare as once thought. We emphasize the importance of early diagnosis in such lesions, especially in slow-to-heal wounds and undiagnosed neck lumps.