We report the case of a 28-year-old woman initially diagnosed with a left peritonsillar abscess, which was drained, resulting in clinical relief. Twelve days later, a bulge was observed in the posterior pharyngeal wall. CT and MRI showed a tumour with destruction of atlas lateral mass, with a soft tissue component in prevertebral, retropharyngeal, left carotid and paraspinal spaces. Biopsy and microbiological study confirmed the presence of Mycobacterium tuberculosis. Therapy was initiated with isoniazid, pyrazinamide, rifampicin and ethambutol, an occipitocervical-C1-C2 arthrodesis was performed, and the patient improved successfully.
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