Intestinal paracoccidioidomycosis simulating colon cancer

Abstract

We report a case of intestinal involvement of Paracoccidioidomycosis, in a patient considered to have colonic cancer. The diagnosis of this mycosis should be considered when an abdominal mass associated with intra-lesional calcifications on X-ray is observed. CT scans increase the findings.

Neoplasia and paracoccidioidomycosis

“…Other carcinoma diagnoses-instead of this mycotic lesions-were reported, such as colon cancer in case of intestinal involvement [6], laryngeal or intra-oral carcinoma, in the oral and laryngeal involvement by this mycosis [7,8] and posterior fossa tumor in cases of cerebral paracoccidioidomycosis [9,10]. Misdiagnosis of cancer have often caused severe consequences in patientś life and their relationship with their families and community, so clinicians need to be aware of the differential diagnosis of such diseases.…”

Fungal Colitis by Paracoccidioides brasiliensis: a case report

“…Paracoccidioidomycosis (PBM) is a granulomatous systemic mycosis of subacute or chronic progress, caused by a dimorphic fungus called Paracoccidioides brasiliensis [1][2][3][4][5][6][7] , known due to its microscopic aspect of a "pilot's wheel". The disease was first described in 1908 by Adolfo Lutz; in 1930, Floriano Paulo de Almeida named it Paracoccidioides brasiliensis.…”

“…Only in 1971 it was named Paracoccidioidomycosis, and it is also known as Lutz's disease, South American blastomycosis, Brazilian blastomycosis, Lutz-Splendore-Almeida disease and Lutz's mycosis 3 . PBM is considered the most important fungal infection in Latin America, with the incidence of 1 to 3 per 100,000 inhabitants in endemic areas 2 , occurring from Southern Mexico to Northern Argentina 7 . Individuals affected by the disease are mostly men who live and/or develop activities in rural areas 1,8 , between 30 and 59 years old [4][5][6]9 .…”

“…The infection by Paracoccidioides brasiliensis affects primarily the lungs, through inhalation of the fungus, and can spread to several organs and systems, originating lesions in mucosae, lymph nodes, skin and adrenal glands [1][2][3]8 , and it may present general symptoms, including fever, weight loss, weakness and prostration 1,8 . The digestive tract is usually not affected 2,8 , around 2.7% of the cases of PBM, but when it occurs, it may lead to manifestations similar to colorectal neoplasm 2 and inflammatory bowel disease (IBD) 1 .…”

“…The digestive tract is usually not affected 2,8 , around 2.7% of the cases of PBM, but when it occurs, it may lead to manifestations similar to colorectal neoplasm 2 and inflammatory bowel disease (IBD) 1 . The fungus identification is through an anatomopathological analysis of the exudate tissues or culture 2 .…”