Recurrent multiple Rhinosporidiosis with osteolytic lesions in hand and foot. A case report

Disseminated rhinosporidiosis

“…8 However, the tumoural lesions of the shoulders, arm, thigh, leg and wrist, affecting the soft tissues and bones and without initial involvement of the overlying skin, suggest possible haematogenous spread. 6 Trauma, in the form of a road traffic accident, modified the course of our patient's disease in two distinct ways. While the breach in the skin overlying the wrist lesion resulted in rapid growth into a fungating mass, the subcutaneous swellings over both shoulders grew rapidly to rupture and discharge pus-like fluid.…”

Osseous involvement in rhinosporidiosis

“…Bony involvement is rare. Isolated osteolytic lesions have been reported involving the talus,7 tibia,89 femoral condyle,210 hand and feet,11 calcaneum,12 and clavicle 13. Dissemination to anatomically unrelated sites is mainly attributed to hematogenous spread 5.…”

“…Differential diagnosis includes tumorous conditions such as giant cell tumor,11 chondrosarcoma,8 other sporoidal infections and granulomatous conditions, which have to be excluded by histopathology. The sporangium of R. seeberi is larger and has thicker walls (diameter of 50-100 mm vs. 20-80 mm) as compared with Coccidioides immitis .…”

Rhinosporidiosis — a report of two cases

“…Dissemination to anatomically unrelated sites is mainly attributed to hematogenous spread [4]. Apart from these; a possibility of lymphatic spread has also been considered [5].…”