Pelvic peritoneal oxyuriasis simulating metastatic carcinoma. A case report

Chemotherapy of enterobiasis (oxyuriasis)

Enterobius vermicularis (syn. Oxyurus vermicularis), also known as pinworm or seatworm, is the causative agent of human enterobiasis (oxyuriasis). The disease is more prevalent in temperate regions and is facilitated by factors such as overcrowding in schools and family groupings, as well as inadequate personal and community hygiene. Although the infection is more likely to occur in lower socioeconomic groups, enterobiasis has been reported to affect virtually every level of the general population and especially children. In the great majority of cases, enterobiasis is asymptomatic. One common symptom is intense pruritus ani that in some patients can lead to insomnia, restlessness and irritability. Scratching may cause skin irritation, and in more serious cases, eczematous dermatitis, haemorrhage or secondary bacterial infections. Ectopic migration of E. vermicularis often results in pinworm infestation of the female genital tract often causing granulomas of the uterus, ovary and the fallopian tubes and pelvic peritoneum. Anthelmintic therapies for enterobiasis are successful and include mebendazole, albendazole and pyrantel pamoate. Mass medication of affected groups reduced symptoms rapidly, progressively and in a cost-effective way.

Live female Enterobius vermicularis in the posterior fornix of the vagina of a Korean woman

A 33-year-old Korean woman, para 2. visited an obstetrics and gynecology clinic, Kumi-shi, Kyongsangbuk-do, due to postcoital spotting and flank pain. She had a tubal ligation 7 years before and demonstrated back pain during menstruation. She revealed a foul smelling discharge without complaint of itching. Enterobius vermicularis eggs were demonstrated during microscopic examination of a smear taken from the posterior fornix of the vagina. On endoscopic examination of her vagina, a live worm was found in the posterior fornix. The worm was removed and identified as a female E. vermicularis based on morphology. This is the first case report of vaginal enterobiasis in Korea.

Enterobiasis of the ovary in a patient with cervical carcinoma in situ

BACKGROUND

Enterobiasis occurs throughout the female genital tract and may involve peritoneal surfaces. It is generally an incidental finding at surgery or at autopsy but occasionally is symptomatic. Most of the superficial lesions are composed of granulomas with variable fibrosis in which diagnostic eggs are found, often associated with degenerated adult worms. Multiple histologic sections may be required to establish the diagnosis in older lesions.

CASE

A case of enterobiasis of the ovary in a patient with squamous-cell carcinoma in situ of the cervix is presented. The features of enterobiasis are discussed.

CONCLUSION

The importance of mistaking such lesions for ovarian cancer is discussed.

Disseminated intraperitoneal oxyuris granulomas

The threadworm, enterobius (oxyuris) vermicularis, is an nematode which may inhabit the human terminal ileum, colon and appendix. Its presence in ectopic sites is uncommon. We describe a case of generalized intraperitoneal oxyuris granulomas detected as an incidental finding at laparotomy for tuboovarian abscess.