Association between non-tuberculous mycobacterial infection and aerodigestive cancers: A case series highlighting different features, sequence and association

Non-tuberculous mycobacterial lung disease (NTM-LD) is increasingly recognized as an important cause of chronic respiratory infections. Diagnosing NTM infection in patients with a history of cancer can be delayed, or overlooked, due to potential overlapping symptomatology and similarities among radiographic features, including lung masses, cavities, and nodules. This retrospective case series aims to demonstrate the variable association of NTM-LD and aerodigestive cancers and how in some cases the diagnosis of NTM-LD can be delayed in patients with malignancy. Six patients with biopsy proven aerodigestive malignancy (either lung or head & neck cancer) and culture positive NTM infection were identified through a retrospective review of medical records between 1/1/2013 and 9/20/2020. Their demographic characteristics and clinical course are described to help elucidate both similarities and differences in presentation and diagnosis. Awareness of the association of NTM-LD and lung malignancy may help in early identification of these potential comorbidities and hence influence proactive diagnosis and management.