Filariasis of the Breast Mimicking Inflammatory Carcinoma

Cytological diagnosis of microfilaria coexistent with suspected malignancy of breast and ovary in a young pregnant female

Filariasis is a major health issue of tropical and subtropical regions and is endemic in India. It is rarely seen in cytological smears, exfoliative scrapings or in effusions. We present the case of a 29-year old female with filaria found on cytological examination of both breast and ovary.

Breast filariasis masquerading as carcinoma: Cytologic diagnosis in two cases

Filariasis is a common public health problem in the Indian subcontinent. Microfilariae are usually detected in the peripheral circulation; however, the clinical manifestations are related to the lymphatic system primarily. The breast is an uncommon site for filariasis, and the lesion clinically mimics malignancy. We should consider filariasis in the differential diagnoses of breast lumps, especially in endemic areas. Fine-needle aspiration cytology from the breast lump allows easy detection of filarial infection, and this can be managed by medical treatment, thereby avoiding surgical procedures.

Filariasis presenting as a breast lump

Lymphatic filariasis is common in Myanmar. Filariasis of breast is rare. This is a case report of filariasis presenting as breast lump.

Breast filariasis

Filariasis is a global health problem and is a major social and economical burden in tropical countries in Asia, Africa and few of the South American countries [1,2]. In india, filariasis endemic in number of states including Bihar, Kerala, Uttar Pradesh, Andhra Pradesh and Tamil Nadu is found chiefly along the banks of rivers and sea coastal areas.

We present a case of 28 year female patient who presented with lump in her left breast for three months and was not associated with pain or discharge from nipple. Fine needle aspiration cytology (FNAC) showed live adult filarial worm along with various stages of filariasis such as microfilaria, adult filaria and embryonated eggs of adult gravid female worm.

In the world the largest number of filarial cases occur in India and about 600 million people live in endemic areas. Despite the huge number of people affected worldwide, it is quite rare to find microfilaria in routine cytological smears and body fluids. Filariasis of the breast is an uncommon condition and can cause a diagnostic dilemma. Hence, a high index of suspicion, particularly in patient from endemic areas, should be kept in mind so as to avoid surgical measures.

Adult filarial worm from the breast aspirate of a young man

Microfilariae and adult filarial worm have been incidentally detected in fine needle aspirates of various lesions in clinically unsuspected cases. Here we report a male patient who presented with a tender breast nodule and single enlarged lymph node. Fine Needle Aspiration (FNA) yielded 1 ml of yellow coloured fluid and single thread like worm measuring 6 × 0.2 cm. A diagnosis of breast abscess with a worm morphologically consistent with filariasis was offered. A follow up visit after 2 months showed regression of the breast lesion and the lymph node. Filariasis of the breast is an uncommon condition and can cause a diagnostic dilemma at times. FNA cytology appears to be a more convenient and effective diagnostic tool in patients with mass lesions. Demonstration and identification of the parasite in smears helps in avoiding surgical excision and early institution of prompt therapy especially in young patients.