Abstract
A 44-year-old man was admitted because of a mass on his left anterior chest wall. Palpation of the mass revealed a smooth, elastic-hard nodule measuring 1.5cm in diameter that was not fixed to the skin or underlying tissue and could be moved readily. Tumor excision was performed under local anesthesia. Histological examination revealed a foreign body granuloma with some degenerated nematode parasites. The worms measured 87.5×295μm-143×345μm in diameter, and had a 15-20μm thick cuticle with 3-4 distinct layers without external longitudinal ridges. They had well-developed lateral chords with distinct internal longitudinal ridges. The hypodermis, muscle layer, digestive tract, and reproductive organs of the worms could not be differentiated due to severe degenerative changes. The worms were thus diagnosed as immature Dirofilaria immitis based on their morphological features, size, and the site of parasite infection. This is the fourteenth human subcutaneous dirofilariasis case, and is the first case of extra-pulmonary dirofilariasis reported in Akita prefecture.
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More From: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
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