Incidental Histopathological Identification of Actinomyces Colonization within a Benign Left True Vocal Fold Polyp

Persistent hoarseness is a common presenting complaint in otolaryngology and warrants thorough evaluation to exclude underlying laryngeal pathology. Benign vocal fold polyps are frequently associated with chronic phonotrauma, smoking, and laryngeal irritation. In contrast, laryngeal involvement by Actinomyces species is exceedingly uncommon, and incidental histopathological identification of Actinomyces colonies within a benign vocal fold polyp has rarely been reported. A 58-year-old retired journalist presented with a two-year history of progressively worsening hoarseness and a one-week history of food regurgitation. Flexible nasopharyngolaryngoscopy demonstrated a polypoidal lesion arising from the left true vocal fold, which was further characterized by contrast-enhanced computed tomography of the neck. The patient underwent endoscopic microlaryngeal excision under general anaesthesia. Intraoperatively, a sessile lesion originating from the anterior commissure involved the anterior one-third of the left true vocal fold with limited subglottic extension. Histopathological examination revealed a benign vocal fold polyp with chronic inflammatory changes and incidental colonies of Actinomyces, without evidence of dysplasia or malignancy. The postoperative course was uneventful, and the patient's voice improved markedly during followup, with no evidence of residual disease. This case highlights the importance of comprehensive evaluation of persistent hoarseness and routine histopathological examination of all excised laryngeal lesions. The presence of Actinomyces colonies within a benign vocal fold polyp most likely represents secondary colonization of chronically inflamed tissue rather than invasive laryngeal actinomycosis. Recognition of this rare histopathological finding is essential to avoid misdiagnosis and unnecessary antimicrobial therapy while emphasizing the importance of clinicopathological correlation.