Summary
Background. Voice is one of the most effective methods of communication. Loss of voice disrupts educational, social progress, health and self-esteem of children. In the literature, the prevalence of pediatric voice disorders is as high as 40% in school- aged children. The reasons of dysphonia are very various, but the vast majority are benign. In rare cases, vocal cord lesions can be the first symptom of malignant process.
Case report. We report a rare case of a 17-year-old male who presented to primary care physician with a 3 months history of hoarseness and cough. The pa tient reffered to ear-nose-throat doctor. Antimicrobial therapy in suspected case of bacterial laryngitis was pre scribed, but in effective. There fore evaluation of patient was continued. Imagining investigations re vealed enlarged mediastinum with multiple patho logical masses. Biopsy of the mediastinal lesions confirmed non-Hodgkin primary mediastinal B-cell lymphoma (PMBL). In addition, videolaryngostroboscopy showed an immobile left vocal cord. Based on the results, the patient went on to receive polychemotherapy and voice therapy.
Conclusions. PMBL is one of the most common mediastinal tumours in childhood. This lymphoma presents with aggressive clinical course and rapid progression in the mediastinum. For this reason, laryngeal or phrenic nerve can be damaged and cause dysphonia. Persistent hoarse ness for over 3 weeks, requires referral for direct visualization. Polychemotherapy is the main treatment of PMBL. Over all survival without unfavourable-risk has a good prognosis and is above 90%. Voice therapy is invaluable treatment method of vocal cord paresis and paralysis for children and often helps to avoid surgery procedures.
