An Unusual Cause of a Breast Mass in a Patient from China

Ruvandhi R. Nathavitharana Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Division of Breast Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts

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Kristin Fleischmann-Rose Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Division of Breast Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts

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David S. Yassa Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Division of Breast Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts

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Michael D. Wertheimer Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Division of Breast Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts

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Carolyn D. Alonso Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Division of Breast Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts

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Sparganosis is a parasitic infection caused by Spirometra spp. and often presents as a subcutaneous swelling, most commonly noticed in the abdominal wall or extremities. Amphibians such as frogs ingest infected copepods (crustaceans that have ingested coracidia, i.e., Spirometra spp. embryos) and serve as a secondary intermediate host. Complete surgical excision is recommended for definitive diagnosis and treatment. Granulomatous inflammation is the most common histologic finding. Although dissemination can occur, most cases are localized. Serum enzyme-linked immunosorbent assay (ELISA) has been suggested as a potential surveillance tool. Medical therapy with antiparasitic agents, such as praziquantel, is not typically recommended but may be effective at high doses. Preventing recurrence thus depends on adequate surgical removal of the parasite. We report a case of a breast mass caused by sparganosis infection in a Chinese female whose likely exposure was due to frog consumption. The diagnosis was confirmed on surgical excision and no systemic antiparasitic therapy was required.

Author Notes

* Address correspondence to Ruvandhi R. Nathavitharana, Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Lowry Building, Suite GB, 110 Francis Street, Boston, MA 02215. E-mail: rnathavi@bidmc.harvard.edu

Authors' addresses: Ruvandhi R. Nathavitharana, David S. Yassa, and Carolyn D. Alonso, Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, E-mails: rnathavi@bidmc.harvard.edu, dyassa@bidmc.harvard.edu, and calonso@bidmc.harvard.edu. Kristin Fleischmann-Rose and Michael D. Wertheimer, Division of Breast Surgery, Beth Israel Deaconess Medical Center, Boston, MA, E-mails: kfleisch@bidmc.harvard.edu and mwerthei@bidmc.harvard.edu.

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