Ovarian Manson's Schistosomiasis: Rare Diagnosis or Underestimated Prevalence? / Esquistossomose mansônica no ovário: diagnóstico raro ou prevalência subestimada?

Abstract The occurrence of Manson's schistosomiasis in organs of the female reproductive tract is an uncommon event, given that the etiological agent for this disease is a blood parasite that inhabits the mesenteric veins. In this case report, a 45-year-old female patient reported that her first symptoms had been strong pain in the left iliac region around two years earlier. An endovaginal pelvic ultrasonography showed that the left ovary was enlarged, and the report suggested that this finding might be correlated with clinical data and tumor markers. After being examined at several healthcare services, the patient was referred to an oncology service due to suspected neoplasia, where she underwent a left ovariectomy. The result from the histopathological examination showed the presence of granulomatous inflammatory processes surrounding both viable and calcified eggs of Schistosoma mansoni. There was no evidence of any neoplastic tissue. The patient was medicated and followed-up as an outpatient.

Resumo A ocorrência da esquistossomose mansônica em órgãos do aparelho reprodutor feminino é um evento pouco comum, tendo em vista que o agente etiológico desta doença é um parasito sanguíneo que habita as veias mesentéricas. Neste relato decaso, uma paciente de 45 anos referiu como primeira sintomatologia fortes dores na região ilíaca esquerda há cerca de 2 anos. Uma ultrassonografia pélvica endovaginal identificou aumento do ovário esquerdo, e o laudo sugeriu correlacionar tal achado com dados clínicos e marcadores tumorais. Após passar por vários serviços de saúde, a paciente foi encaminhada para um serviço de oncologia por suspeita de neoplasia, sendo submetida a uma ovariectomia à esquerda. O resultado do exame histopatológico evidenciou a presença de processos inflamatórios granulomatosos em torno de ovos viáveis e calcificados de Schistosoma mansoni. Não houve qualquer evidência de tecido neoplásico. A paciente foi medicada, e seguiu em acompanhamento ambulatorial.

One case report of ectopic schistosomiasis in fallopian tube in Jingmen City / 中国血吸虫病防治杂志

One cases of ectopic schistosomiasis in fallopian tube was found by the histopathological examination in Jingmen City. After surgery and anthelmintic treatment with praziquantel,the curative effect was satisfactory. This case suggests that in schistosomiasis endemic area,the imaging technology and tissue pathological examination should be used sufficiently for the dif-ferential diagnosis of ectopic schistosomiasis,so as to reduce misdiagnosis.

First record of prostatic schistosomiasis in Pernambuco, Brazil: signs of chronicity in an endemic disease

Schistosomiasis has affected the rural population of Pernambuco, Brazil, for centuries. The hepatosplenic and neurological manifestations of this parasitosis have often been described. However, prostatic schistosomiasis caused by Schistosoma mansoni had never been registered in Pernambuco, thus the importance of this particular case being reported. Case presentation: This report records the first case of prostatic schistosomiasis in Pernambuco. A 51-year-old patient underwent partial prostatectomy due to possible cancer and was diagnosed with this ectopic form of schistosomiasis. After the surgical procedure, stool samples were collected to run Kato-Katz parasitological tests, which were positive for S. mansoni, thus confirming that the patient was still infected. Laboratory blood tests and clinical examination showed alterations in liver function and confirmed the presence of hepatointestinal damage. Patient monitoring evidenced that the prostate-specific antigen levels remained high and, one year after the first surgical intervention, a new prostatic puncture showed that schistosomiasis and fibromatosis lesions remained present. It is noteworthy that after triple praziquantel treatment (April 2014, July 2014, February 2015) parasitological stool examinations were all negative for S. mansoni. In conclusion this accidental diagnosis of prostatic schistosomiasis raises doubts regarding the ability of healthcare services to identify and treat ectopic schistosomiasis. The persistently high levels of PSA even after surgical and pharmacological treatment, indicate irreversible damage to tissue caused by S. mansoni. Therefore, healthcare services need to be prepared to investigate and diagnose these cases, with a view to preventing chronic sequelae through early treatment

Ectopic schistosomiasis: description of five cases involving skin, one ovarian case and one adrenal case / Esquistossomose ectópica: descrição de cinco casos de envolvimento da pele, um do ovário e um da glândula supra-renal

Seven cases of patients with ectopic schistosomiasis from the State of Sergipe, Brazil, are presented (five involving skin, one ovarian and one adrenal). Data were collected from surveying the clinical records and anatomopathological reports in the files of the dermatology and pathology clinics of the University Hospital of the Federal University of Sergipe, from 1995 to 2005. The patients' mean age at diagnosis was 21.1 years. In the dermatological cases, full cures were achieved after treatment with oxamniquine. In the ovarian case, there was an association with embryonic carcinoma: this patient underwent surgery with adjuvant chemotherapy and praziquantel treatment, with satisfactory evolution. The adrenal case was associated with adenoma.

São apresentados sete casos de esquistossomose ectópica (cinco de pele, um de ovário e um de supra-renal) procedentes do Estado de Sergipe, coletados a partir de pesquisa de prontuários e laudos anátomo-patológicos nos arquivos dos Serviços de Dermatologia e de Patologia do Hospital Universitário da Universidade Federal de Sergipe, entre os anos de 1995 e 2005. A média de idade dos pacientes ao diagnóstico foi de 21,1 anos. Nos casos dermatológicos, houve melhora total das lesões após tratamento com oxamniquine. No caso de ovário houve associação com carcinoma embrionário; a paciente foi submetida à cirurgia com quimioterapia adjuvante e praziquantel, evoluindo satisfatoriamente. O caso de supra-renal estava associado a adenoma.