Breast sparganosis: Mammographic and ultrasound features

Abstract

Sparganosis is human infestation by a larval form of an animal tapeworm, genus Spirometra. Human infestation is considered to be acquired by ingestion of water snakes, frogs, or drinking water contaminated with the larval stage of the tapeworm.'The frequent locations of infection in humans are subcutaneous tissue or skeletal muscle of the lower extremity, abdominal wall, abdominal viscera, chest, breast, scrotum, and brain.' The mammographic and sonographic findings in a case of breast sparganosis were reviewed. Sonographic feature in the breast was correlated with the sonography of the operatively extracted living worms from the breast and pathologic data. Mammography showed multiple, lobular, marginated, amorphic, solid masses without calcification. Sonography showed elongated, folded band-like hypoechoic structures in a heterogenous hyperechoic mass, which was proved to be the empty tunnel and the living worm with surrounding granuloma on pathologic examination. Hypoechoic band-like tracts in the mass suggested that tunnel where a worm had migrated because the extracted worm itself in saline solution appeared as a hyperechoic structure with sonography. This hypoechoic tunnel in the heterogenous hyperechoic mass is thought to be a reliable sonographic finding of breast sparganosis. CASE REPORTA 76-year-old woman was referred with a nontender, softly palpable mass in the right upper quadrant of the breast that had been present for 3

Breast Sparganosis Incidentally Detected by FDG PET/CT

“…In the present case, typical radiopaque tubular structures with multiple curves are clearly demonstrated in the upper outer quadrant of the right breast. Sometimes, it would be presented as a radiopaque lobular, solid mass without microcalcification in the breast, which is similar to that of breast cancer or benign tumors, such as fibroadenomas [12,13,16]. Also, the tubular structures with hypoechoic shadow are demonstrated by breast ultrasonography in the present case.…”

“…Breast sparganosis can mimic breast neoplasms on conventional radiological imaging of the breast, such as mammography or ultrasonography [10,11]. However, in most cases, breast sparganosis has unique radiological features on mammography or breast ultrasonography, because infected larvae form tubular structures in the subcutaneous fat layer of the breast [12,13]. Here, we report a case of incidentally detected breast sparganosis by 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), which the patient was undergoing for staging work ups of gall bladder (GB) cancer.…”

Breast Sparganosis Mimicking Ipsilateral Breast Tumor Recurrence in a Patient with a History of Breast Conserving Surgery: A Case Report

“…The mammographic findings of the breast sparganosis are irregular, lobular or tubular structures or amorphous solid masses (3,4,6,9,10). The ultrasonographic findings of breast sparganosis are elongated, folded, tubular hypoechoic structures and serpiginous echogenic lesions, which correlate with pathologic findings (1, 3, 4, 6, 8-10).…”

“…To the best of our knowledge, 41 cases of breast sparganosis have been reported based on the Korean Medical (KM) database and the Korean association of medical journal editors (KAMJE) database, which were searched to include information from Korean journals that are not included in international citation indexes (3,4,6,(8)(9)(10)(11)(12). It is transmitted by drinking larvaecontaining water or consuming raw secondary intermediate hosts such as frogs or snakes (2).…”

A case of breast sparganosis

“…The hypoechoic tubular structure revealed by sonography was regarded as a remnant formed by an active moving of sparganum (Hong et al, 1989;Chung et al, 1995). The tubular structure appeared to have just undergone the -188 - process of active healing after the worms pass through (Hong et al, 1989).…”