Subcutaneous Entomophthoromycosis mimicking soft tissue tumour: Report of two cases in Maharashtra, India

Abstract

Entomophthoromycosis (subcutaneous zygomycosis) is a sporadic subcutaneous infection that is largely restricted to tropical areas of Africa, Asia, and South America. It presents in two clinically distinct forms. Subcutaneous zygomycosis, caused by Basidiobolus ranarum and rhinofacial zygomycosis caused by Conidiobolus coronatus. Neither of these two forms occur preferentially in patients with underlying disease or defective immunity1. Entomophthoromycosis is characterized by the formation of firm and nontender swellings, generally on the extremities, trunk, & rarely other parts of the body2. Subcutaneous zygomycosis can also mimic soft tissue tumors3. We present 2 cases with large, rapid-growing zygomycotic subcutaneous lesions, initially misdiagnosed as a soft tissue tumor, emphasizing importance of rapid & thorough diagnosis with a high index of suspicion, especially in endemic areas. Our experience with these cases highlights importance of awareness & early recognition of this condition to prevent disfigurement produced by advanced disease, misdiagnosis, & unnecessary delay in treatment. Subcutaneous zygomycosis should be considered in differential diagnosis of subcutaneous swellings, especially in tropical countries. Treatment should be given on histopathological diagnosis as fungus is difficult to grow in culture with immunology & serology having limited basis in use for diagnostic purposes.