Laryngeal blastomycosis: A commonly missed diagnosis - Report of two casesand review of the literature

Blastomycosis is a relatively uncommon fungal disease that most commonly af fects the lungs. Other organs may be involved, usually secondary to dissemi nation of the organism. Laryngeal blastomycosis may occur in isolation from active pulmonary disease. The signs, symptoms, clinical features, and path ological findings of laryngeal blastomycosis mimic those of squamous cell c arcinoma. Misdiagnosis may result in inappropriate treatment with potential morbidity. Proper understanding of the clinical presentation and familiari ty with the histopathologic features of this disease are therefore imperati ve. In this paper, we report 2 cases of laryngeal blastomycosis, 1 of which was misdiagnosed as squamous cell carcinoma, clinically and microscopicall y, with consequent radiotherapy and laryngectomy. In the other case, a clin ical diagnosis of glottic squamous cell carcinoma was rendered. However, bl astomycosis was identified in a biopsy specimen. We also review cases of is olated laryngeal blastomycosis that have been reported in the English-langu age literature during the last 80 years. A number of those cases were misdi agnosed clinically and microscopically as squamous cell carcinoma.