Maria Roethlisberger1, Rachel Wuerstlein2, Michael Majores3, Irene Müller-Stöver4, Hanns M Seitz5, Kerstin Rhiem1, Stefan Kraemer1, Peter Mallmann1, Reinhard Büttner6, Nadia Harbeck2. 1. Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany. 2. University Hospital of Munich, Breast Center, Ludwig Maximilian's University Munich, Germany ; University Hospital of Munich, Comprehensive Cancer Center, Ludwig Maximilian's University Munich, Germany. 3. CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany ; Department of Pathology, University Hospital of Bonn, Germany. 4. Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital of Dusseldorf, Germany. 5. Department of Microbiology, University Hospital of Bonn, Germany. 6. CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany ; Department of Pathology, University Hospital of Cologne, Germany.
Abstract
BACKGROUND: The term filariasis comprises a group of parasitic infections caused by helminths belonging to different genera in the superfamily Filaroidea. The human parasites occur mainly in tropical and subtropical regions, but filariae are also found in temperate climates, where they can infect wild and domestic animals. Humans are rarely infected by these zoonotic parasites. PATIENTS AND METHODS: A 55-year-old patient presented with a new-onset, subcutaneous, non-tender palpable mass in the right axilla. Ultrasonography showed a 1.3-cm, solid, singular encapsulated node. Sonography of the breast on both sides, axilla and lymphatic drainage on the left side, lymphatic drainage on the right side, and mammography on both sides were without pathological findings. The node was excised under local anesthesia as the patient refused minimal invasive biopsy. RESULTS: On histopathological examination, the tail of a parasite of the group of filariae was found. The patient revealed that she had stayed in Africa and Malaysia for professional reasons. 6 months before the time of diagnosis, she had also suffered from a fever and poor general condition after a trip abroad. The patient was referred for further treatment to the Institute for Tropical Medicine at the University of Dusseldorf, where a treatment with ivermectin was conducted on the basis of positive staining with antibodies against filariae. CONCLUSION: Our case demonstrates the importance of interdisciplinary collaboration between breast center, pathology, and other specialties such as microbiology and tropical medicine.
BACKGROUND: The term filariasis comprises a group of parasitic infections caused by helminths belonging to different genera in the superfamily Filaroidea. The human parasites occur mainly in tropical and subtropical regions, but filariae are also found in temperate climates, where they can infect wild and domestic animals. Humans are rarely infected by these zoonotic parasites. PATIENTS AND METHODS: A 55-year-old patient presented with a new-onset, subcutaneous, non-tender palpable mass in the right axilla. Ultrasonography showed a 1.3-cm, solid, singular encapsulated node. Sonography of the breast on both sides, axilla and lymphatic drainage on the left side, lymphatic drainage on the right side, and mammography on both sides were without pathological findings. The node was excised under local anesthesia as the patient refused minimal invasive biopsy. RESULTS: On histopathological examination, the tail of a parasite of the group of filariae was found. The patient revealed that she had stayed in Africa and Malaysia for professional reasons. 6 months before the time of diagnosis, she had also suffered from a fever and poor general condition after a trip abroad. The patient was referred for further treatment to the Institute for Tropical Medicine at the University of Dusseldorf, where a treatment with ivermectin was conducted on the basis of positive staining with antibodies against filariae. CONCLUSION: Our case demonstrates the importance of interdisciplinary collaboration between breast center, pathology, and other specialties such as microbiology and tropical medicine.