Parametrial anisakidosis

Abstract

Anisakidosis is a parasitic infection caused by anisakid nematodes in the genera Anisakis and Pseudoterranova. Infection is not uncommon in the United States due to increased raw seafood consumption. We report the first known case of parametrial anisakidosis in a 42-year-old woman and review existing literature.

Fig 1

Low-power magnification of the mass (left) from the external aspect of the posterior cervix, demonstrating two cross-sections of the anisakid roundworm (arrows) surrounded by fibrous tissue and inflammatory cells (hematoxylin-and-eosin [H&E] staining, ×20 magnification). On higher magnification, narrow Y-shaped lateral cords are seen within the worm cross sections (arrow), characteristic of Anisakis sp. Numerous eosinophils are seen in the granulomatous inflammation to the right of the worm (H&E staining, ×400 magnification).

Fig 2

Coiled anisakid larva in a frozen cod fillet from a local grocery store. The coiled worm measures approximately 5 mm in diameter. This is a common finding in cod fillets.

Fig 3

Schematic demonstrating the retrouterine pouch that contained the Anisakis larva. Note the close proximity of this space to the posterior cervix, demonstrating how the larva and surrounding inflammatory tissue could be mistaken for a mass arising from the cervix. (Courtesy of Mayo Foundation for Medical Education and Research. Reproduced with permission.)