Abstract
A 42-year-old male patient presented with a mass lesion over the dorsum of nose and central face. Initially, all investigations including inflammatory markers, multiple biopsies and fungal stains failed in diagnosing the disease. Eventually, it was diagnosed as rhino-facial conidiobolomycosis by fungal culture and successfully managed with combination antifungal therapy.
Highlights
Granulomatous nasal conditions have wide variety of aetiologies and those can be classified as infective, inflammatory, neoplastic and vasculitis associated diseases
All investigations including inflammatory markers, multiple biopsies and fungal stains failed in diagnosing the disease. It was diagnosed as rhino-facial conidiobolomycosis by fungal culture and successfully managed with combination antifungal therapy
There is a significant delay in diagnosing especially, when all the preliminary investigations and biopsies are inconclusive. We faced such a challenging situation with a slowly progressive mass lesion over the nose and central face diagnosed as Rhino Facial Conidiobolomycosis
Summary
Granulomatous nasal conditions have wide variety of aetiologies and those can be classified as infective, inflammatory, neoplastic and vasculitis associated diseases. There is a significant delay in diagnosing especially, when all the preliminary investigations and biopsies are inconclusive We faced such a challenging situation with a slowly progressive mass lesion over the nose and central face diagnosed as Rhino Facial Conidiobolomycosis. A 42-year -old male manual labourer (coconut plucker) presented with slowly progressive painless swelling over alar of nose for 08 months It has started over left nasal alar and later spread to involve the whole external nose and bilateral cheeks. There were no other co-morbid illnesses such as, diabetes mellitus or other immunocompromised conditions He had undergone left side lateral rhinotomy and medial maxillectomy six years back (2012) for a transitional cell papilloma of left nasal cavity and remained asymptomatic up to current complaint. 1c: CECT scan (axial view) shows contrast enhanced subcutaneous lesion without bony erosions or sinus involvement. (There is evidence of past left medial maxillectomy)
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