Rhinosporidiosis: Report of an extra-ductal facial lesion

Abstract

Rhinosporidiosis is a chronic granulomatous mucocutaneous disease that is endemic in South Asia. It commonly affects men in the second to fourth decade of life. The most common site of infection is the nose or nasopharynx with primary involvement of the parotid duct noted very rarely; only four cases reported in literature. We report a case of a 77 year old male patient who presented with a subcutaneous cheek swelling with no other clinical features to suggest the diagnosis of rhinosporidiosis. An unusual affliction in a patient in the seventh decade of life, at a site not reported previously with no past history of the same makes it imperative to ascertain the known facts about both the organism and the disease. However the histopathological report confirmed the diagnosis which reiterates the need to further study the pathogenesis of this condition.

Palatal rhinosporidiosis: an unusual case report and review of the literature

“…Rhinosporidiosis is a distinctive granulomatous infection of the mucocutaneous zone6. It has been known since ancient time and was first noted in Argentina over 100 years ago4.…”

“…Rhinosporidiosis is a deep-seated and confined infection of mucous membranes. It clinically presents as a polypoid, soft tissue mass most commonly located in the nose, throat, eye, or ear but can also be found in the oropharynx, larynx, trachea, bronchi, and genitourinary tract612. The nose and nasopharynx are affected in 70% of cases, while ocular conjunctiva and other sites are affected in 30% of cases.…”

“…The pathogen forms round and thick-walled sporangia in the sub-mucosal layer of the affected site which appears as white dots on the superficial skin46. Osteolytic bone destruction is also an important clinical sign5.…”

“…Clinically, the disease presents as a polypoid, soft mass of the nose (most common site), eye, conjunctiva, or urethra. Osteolytic bone infiltration is another identifying feature6. Antifungal and/or antimicrobial drugs are not effective against R. seeberi , and the only treatment for rhinosporidiosis is surgical excision of the affected area with deep cauterization to prevent reoccurrence.…”