Abstract
Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis in immunocompetent individuals in Brazil. Ocular infection by PCM is rare; however, when infection does occur, the most common ocular sites involved are eyelid and conjunctiva. A 68-year-old white male presented with a 2-month history of a painless, ulcerated, infiltrative and diffuse whitish lesion located on the right inferior eyelid. A clinical diagnosis of malignant tumor, possibly squamous cell carcinoma, was made. The histopathologic examination showed a hyperplastic epithelium with inflammatory infiltrate of lymphocytes, plasma cells, neutrophils and histiocytes. Large numbers of giant cells were also present. Periodic acid Schiff and Grocott (silver methenamine) stains showed several large round structures with peripheral lateral small budding cells that resembled a “ship’s wheel”. No multinucleated fungi were seen. The fungi varied in size and small forms were round and single fungal structures. A diagnosis of paracoccidioidomycosis was made PCM eyelid infection is rare and can simulate carcinoma both clinically and histopathologically.
References
Marques SA, Lastoria JC, Putinatti MS et al (2008) Paracoccidioidomycosis: infiltrated, sarcoid-like cutaneous lesions misinterpreted as tuberculoid leprosy. Rev Inst Med Trop Sao Paulo 50(1):47–50
Theodoro RC, Candeias JM, Araujo JP Jr et al (2005) Molecular detection of Paracoccidioides brasiliensis in soil. Med Mycol 43(8):725–729
Santo AH (2008) Paracoccidioidomycosis-related mortality trend, state of Sao Paulo, Brazil: a study using multiple causes of death. Rev Panam Salud Publica 23(5):313–324
Cruz AA, Zenha F, Silva JT Jr, Martinez R (2004) Eyelid involvement in paracoccidioidomycosis. Ophthal Plast Reconstr Surg 20(3):212–216
Finamor LP, Muccioli C, Martins MC et al (2002) Ocular and central nervous system paracoccidioidomycosis in a pregnant woman with acquired immunodeficiency syndrome. Am J Ophthalmol 134(3):456–459
Franco M, Montenegro MR, Mendes RP et al (1987) Paracoccidioidomycosis: a recently proposed classification of its clinical forms. Rev Soc Bras Med Trop 20(2):129–132
Paniago AM, Aguiar JI, Aguiar ES et al (2003) Paracoccidioidomycosis: a clinical and epidemiological study of 422 cases observed in Mato Grosso do Sul. Rev Soc Bras Med Trop 36(4):455–459
Martins R, Marques S, Alves M et al (1997) Serological follow-up of patients with paracoccidioidomycosis treated with itraconazole using dot-blot, ELISA and Western-blot. Rev Inst Med Trop Sao Paulo 39(5):261–269
Odashiro AN, Leite LV, Oliveira RS et al (2009) Primary orbital mesenchymal chondrosarcoma: a case report and literature review. Int Ophthalmol 29(3):173–177
Belfort R Jr, Fischman O, de Camargo ZP, Almada A (1975) Paracoccidioidomycosis with palpebral and conjunctival involvement. Mycopathologia 56(1):21–24
Burnier SV, Sant’Anna AE (1997) Palpebral paracoccidioidomycosis. Mycopathologia 140(1):29–33
Rocha GJNM, Nossa LMB, Pinto MR, Marback RL (2002) Palpebral paracoccidioidomycosis: report of three cases. Arq Bras Oftalmol 65(5):575–578
Ferraz E, Cella W, Rocha E, Caldato R (2001) Primary paracoccidioidomycosis of eyelid and conjunctiva. Arq Bras Oftalmol 64(3):259–261
Chojniak R, Vieira RA, Lopes A et al (2000) Intestinal paracoccidioidomycosis simulating colon cancer. Rev Soc Bras Med Trop 33(3):309–312
Garcia I, Barbella R, Dickson S et al (2008) Paracoccidioidomycosis (South American blastomycosis) of the larynx mimicking carcinoma. Am J Med Sci 335(2):149–150
Conant NF, Smith DT, Baker RD, Callaway JL (1971) Manual of clinical mycology, vol 1, 3rd edn. WB Saunders, Philadelphia p 755
Binford CH, Connor DH (1976) Pathology of tropical and extraordinary diseases. Sponsored and supported by Armed Forces Institute of Pathology. The Institute. Washington
Do Valle AC, Costa RL, Fialho Monteiro PC et al (2001) Interpretation and clinical correlation of serological tests in paracoccidioidomycosis. Med Mycol 39(4):373–377
Ricci G, Da Silva ID, Sano A et al (2007) Detection of Paracoccidioides brasiliensis by PCR in biopsies from patients with paracoccidioidomycosis: correlation with the histopathological pattern. Pathologica 99(2):41–45
Coutinho ZF, Silva D, Lazera M et al (2002) Paracoccidioidomycosis mortality in Brazil (1980–1995). Cad Saude Publica 18(5):1441–1454
Campos MV, Penna GO, Castro CN et al (2008) Paracoccidioidomycosis at Brasilias university hospital. Rev Soc Bras Med Trop 41(2):169–172
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Odashiro, A.N., Odashiro, P.R.P., Fernandes, P.I. et al. Eyelid and conjunctival paracoccidioidomycosis simulating carcinoma. Int Ophthalmol 31, 63–67 (2011). https://doi.org/10.1007/s10792-010-9407-7
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DOI: https://doi.org/10.1007/s10792-010-9407-7