103 Kulak Burun Bogaz Ihtis Derg 2009;19(2):103-105 Case Report / Olgu Sunumu B E H B U T C E V A N ŞİR KU LA K BU RU N B O Ğ A Z H A S T A L I K LA R I V E B A Ş B O Y UN C ER R A HİSİ D E R N E Ğ İ . . Relapsing deep neck infection may indicate a coexisting esophagus cancer Tekrarlayan derin boyun enfeksiyonu yandaş bir özofagus karsinomunu işaret edebilir Emin Karaman, M.D., 1 Cihan Duman, M.D., 1 Hasan Mercan, M.D., 1 Reşat Özaras, M.D., 2 Harun Cansız, M.D. 1 Neck abscess and deep neck infections are com- mon diseases. Primary head and neck cancers may present initially with neck abscesses or deep neck infections. This presentation leads to delay of the diagnosis of underlying cancer. Head and neck can- cers which present with deep neck infection initially have rarely been described. We report a case with relapsing deep neck infection who was diagnosed as proximal esophagus squamous cell carcinoma thereafter. Key Words: Deep neck infection; esophagus; neck abscess; squamous cell carcinoma. Boyun apseleri ve derin boyun enfeksiyonları sık görülen hastalıklardır. Primer baş boyun kanserleri, ilk olarak derin boyun enfeksiyonu veya boyun apse- si şeklinde kendini gösterebilir. Bu durum altta yatan kanserin tanısında gecikmeye yol açabilir. İlk olarak derin boyun enfeksiyonları ile kendini gösteren baş- boyun kanserleri nadir olarak tanımlanmıştır. Bu yazıda daha sonradan proksimal özofagus skuamöz karsinomu tanısı konan ve relapslarla seyreden derin boyun apseli bir olgu sunuldu. Anahtar Sözcükler: Boyun apseleri; özofagus; derin boyun enfeksiyonu; karsinom. Deep neck infections and neck abscesses are com- monly seen at otorhinolaryngology field and they are known as the infections that occur in the deep layers of the neck. The most common factors for deep neck infections are intravenous drug abuse, dental infection and pharyngotonsillitis. [1-3] Although head and neck cancers usually pres- ent with neck masses, the initial presentation of a head and neck malignancy may be a neck abscess or a deep neck infection. The reported incidence of the cystic degeneration of cervical lymph nodes caused by Waldeyer’s ring or the thyroid gland is 33 to 55%. [4,5] However, these cystic lymph nodes very rarely become infected. In literature, there are few cases of nasopharyn- geal, laryngeal, hypopharyngeal and thyroid malig- nancies and malignancies of the oral cavity that initially presented with a deep neck infection. [6-8] Because an infection coexistent with malig- nancy is not common, the clinical picture may be complicated and this may lead to a delayed diag- nosis. Additionally, neck abscesses and deep neck infections may show recurrences due to underly- ing head and neck cancer. In this article, we reported a case with proximal esophageal squamous cell carcinoma that initially presented with a deep neck infection. Department of 1 Otolaryngology, 2 Infectious Diseases, Medicine Faculty of Cerrahpaşa University, İstanbul, Turkey Received / Geliş tarihi: July 16, 2007 Accepted / Kabul tarihi: February 6, 2008 Correspondence / İletişim adresi: Emin Karaman, M.D. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Kulak Burun Boğaz Hastalıkları Anabilim Dalı, 34098 Cerrahpaşa, İstanbul, Turkey. Tel: +90 212 - 414 30 00 / 21598 Fax (Faks): +90 212 - 414 34 08 e-mail (e-posta): drkaramane@yahoo.com.tr