Pseudo-tumor of the scrotum, a rare clinical presentation of dirofilariasis: a report of two autochtonous cases due to <i>Dirofilaria repens</i>

Leccia, Nathalie; Patouraux, Stéphanie; Carpentier, Xavier; Boissy, C.; Giudice, P. Del; Parks, Scott K.; Michiels, Jean François

doi:10.1179/2047773212y.0000000029

Cited by 21 publications

(14 citation statements)

References 6 publications

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“…Human dirofilariasis of the male reproductive system is rare, with about 20 cases reported in Europe, with localization of the parasite most often in the testicles, epididymis, and the spermatic cord [6]. Most authors assume that the frequency of such localization of the parasite is between 2 and 4% worldwide [7].…”

Section: Discussionmentioning

confidence: 99%

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Epididymal Dirofilariasis in a Child: First Case Report from Bulgaria

et al. 2018

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Objective: To present case of a child with epididymal dirofilariasis. Clinical Presentation and Intervention: An 11-year-old boy was admitted to the Clinic of Pediatric Urology for elective surgery treatment of epididymal cyst on the left side. After removal, the cyst was sent for histological examination. Microscopic examination of the histological slides revealed cross-sections of a nematode belonging to Dirofilaria spp., differentiated morphologically as D. repens. After surgery, the patient recovered completely. Conclusions: In most parts around the world, dirofilariasis is a rare and neglected infection. Nevertheless, the clinicians and pathologists must be informed about it.

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Section: Discussionmentioning

confidence: 99%

“…The clinical features of human dirofilariasis are not specific. Since the resulting infectious nodule in the male genitalia is frequently indistinguishable clinically from a malignant neoplasm, when systemic signs are absent and urine analysis is negative, the nodule is usually removed surgically [6, 8]. …”

Section: Discussionmentioning

confidence: 99%

Epididymal Dirofilariasis in a Child: First Case Report from Bulgaria

et al. 2018

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“…(Only 21 cases reported) [17,18].and can be mistaken for scrotal malignancy, resulting in unnecessary extensive operation [19].…”

Section: Discussionmentioning

confidence: 99%

Human Dirofilariasis Presenting as Scrotal Mass

Chiaramonte¹

2017

JURNOA

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Surgery Unit complaining a painless nodule on his left hemi scrotum (ASM). He had neither pathological history nor was in contact with dogs or other animals and never visited other countries.The physical examination revealed no pathological findings except for a single painless hard nodule of 1 cm at the apex of the scrotum with any connection to the testis. The skin over the nodule was normal without any signs of inflammation and the inguinal lymph nodes were not palpable Routine laboratory tests of the blood showed no abnormal values for the age. Tumors markers as βHCG and α-fetoprotein were within normal range.Suspecting an extra-testicular neoplasm an ultrasound scan with high-resolution linear probe 10 -12 MHz of the nodule was performed. It showed the presence of an anechoic cystic formation without any vascularization in its contest or vascular pole at the color-doppler integration. Within a cyst mass a tubular coiled structure with parallel echogenic wall in continuous movements was found: to identify the species of worm specialist opinion was requested.The characteristic pattern movements of the nematode (filaria dance sign-FDS) led to diagnosis of human subcutaneous dirofiliasis (HSD). Testicular tissue was normal.(FIGURE 1).The surgery was performed under general anesthesia with minor surgery approach by a transversal scrotal incision of less than 1 cm over the nodule. The mass wasn't in connection with testicular or funicular structures. It was isolated from the dartos without any damage to the capsule and was enucleated intact (FIGURE 2).The hystopathological examination showed a simil-cystic structure with granulomatous inflammatory wall with a high number of eosinophils and a tubular structure of 10 cm of length inside moving when placed in physiological solution (FIGURE 3).The diagnosis of infection from Dirofilariarepens was based on the morphological characteristic of the worm that displayed the tipical features of a female. AbstractA large spectrum of pathology may present in children as an asymptomatic scrotal mass (ASM) ranging from congenital to neoplastic lesions.We observed a 11 months old child referred to us for suspicion of neoplasm presenting with an asymptomatic scrotal mass.High frequency scrotal sonography enabled diagnosis of nematode infection (Dirofilaria repens): viability of the adult worms was assessed by looking for the animated documentation of filarial dance sign (FDS).Differentiation from malignancy allowed an appropriate management consisting in minor surgery.Human Subcutaneous Dirofilariasis (HSD) is an endemic zoonosis spread throughout the world, with dogs and cats being the definitive host for this parasite. Human infections caused by Dirofilaria repens have been reported in Eastern Europe, Mediterranean area, central and Southern Asia, transmitted by various species of mosquitoes and usually presented as subcutaneous nodule.Extra-testicular pathologies are encountered relatively infrequently but awareness of different possible etiology avoids unnecessary extensive s...

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“…Subcutaneous migration of the worm may result in local swellings with changing localisation (creeping eruption) [31]. In addition, rare cases of organ manifestation have been reported, affecting the scrotum, male genitals, female breast, lymphatic glands and peritoneum [2,[32][33][34][35][36][37][38]. OD is a variation of subcutaneous dirofilariasis with parasite localisation in the eye area [30].…”

Section: Introductionmentioning

confidence: 99%

Dirofilariasis in Russian Federation: a big problem with large distribution

Tatyana¹,

Alexey²

2018

Russ Open Med J

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Dirofilariasis caused by Dirofilaria spp. is an important vector-borne and largely zoonotic disease. In Russia, dirofilariasis is caused by two agents D. immitis and D. repens. The present article provides detailed analyses of human and canine dirofilariasis methods of diagnosis, treatment, and prevention of the disease, with particular reference to the control programmes. Information has been summarised from literature in different languages that are not readily accessible to the international scientific community. Human dirofilariasis was first registered in Russia in 1915, and recent reports showed that the total number of infected humans increases on average by 1.8 times every three years. Human dirofilariasis was registered in 42 federal subjects. Totally 1162 cases of subcutaneous dirofilariasis were registered in the Russian Federation between 1915-2013, the most frequently type of subcutanious dirofilariasis was ocular dirofilariasis (more than 50% cases). Seven cases of pulmonary dirofilarisis were registered in Russia. The treatment of human dirofilariasis includes surgical removal of worms only; in result preventive measure have major importance for reducing risk of Dirofilaria infection. Control programmes have been implemented by the government at all administrative levels including diagnosis and treatment of patients, identification, isolation, and treatment of infected dogs, monthly chemoprophylactic of dogs during spring-summer periods, and regular vector control.

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Pseudo-tumor of the scrotum, a rare clinical presentation of dirofilariasis: a report of two autochtonous cases due to Dirofilaria repens

Cited by 21 publications

References 6 publications

Epididymal Dirofilariasis in a Child: First Case Report from Bulgaria

Epididymal Dirofilariasis in a Child: First Case Report from Bulgaria

Human Dirofilariasis Presenting as Scrotal Mass

Dirofilariasis in Russian Federation: a big problem with large distribution

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