Introduction: Mycetoma is a chronic and progressive subcutaneous granulomatous infection characterized by painless swelling, draining sinus tracts, and purulent discharge. The term eumycetoma is used to describe an infection caused by fungi, while an actinomycetoma is used to describe an infection caused by filamentous bacteria.^[1]

Case Description: We describe a case report of a 56 years old man who presented with swelling on left thigh since 1 year. Clinically swelling resembled lipoma/soft tissue tumor as it presented as well circumscribed mass and there was no skin involvement/discharging sinuses. Final diagnosis of mycetoma was made on histopathological examination. Patient had complete resolvement of symptoms after excision and anti fungal treatment.

Conclusion: Mycetoma without skin involvement is very unusual presentation. Clinically it is very difficult to identify swelling as mycetoma unless there is skin involvement/discharging sinuses or high index of suspicion.^[2] Careful histopathological examination and anti fungal treatment thus becomes very important in such cases.

Keywords: Mycetoma thigh, unusual presentation, eumycoticmycetoma, tenosynovial giant cell tumor, discharging sinus, fungal filaments, lipoma.

1. Jawetz, Melnick and Adelberg’s medical microbiology 27/e
2. Grover A, Nagaraj P, Joseph VM, Gadi D. Unusual Presentation of Mycetoma of the Foot: A Rare Case Report. Journal of Orthopaedic Case Reports 2017 Jan-Feb;7(1):12-15.
3. Lichon V, Khachemoune A. Mycetoma: a review. Am J ClinDermatol. 2006;7 (5):315–321.

Prachiti S Gokhe

Department of General Surgery, Grant Government Medical College and Sir J. J. Group of Hospitals, Mumbai, India