Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Oct;12(10):22-25.
doi: 10.13107/jocr.2022.v12.i010.3350.

An unusual presentation of mycetoma around knee joint as a subcutaneous mass - A case report

Bhupendar Singh  1 , Rishita Gehlot  2 , Medhavi Saxena  3 , Nandlal Bharwani  4 , Kishore Raichandani  5 , Mahesh Bhati  4
Affiliations
Case Reports

An unusual presentation of mycetoma around knee joint as a subcutaneous mass - A case report

Bhupendar Singh et al. J Orthop Case Rep. 2022 Oct.

Abstract

Introduction: Mycetoma is a form of chronic granulomatous disease which involves subcutaneous tissues and causes bone destruction in advanced stages. The characteristic features are sinus formation, granules formation, and mass in subcutaneous region.

Case report: A 19-year-old male presented to our out-patient clinic with complaint of a painless swelling around the medial aspect of the right knee joint for 8 months with no sinus or discharge of granules. Pes anserinus bursitis was thought of as differential diagnosis for the present condition. "Staging-classification of mycetoma" is commonly used for classifying mycetoma and as per classification, the present case had Stage-A.

Conclusion: Single-stage local excision was performed and supplemented with anti-fungal agent for 6 months, which showed good outcome at the final follow-up of 13 months.

Keywords: Eumycetoma; antifungal agents; knee; wide excision.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Axial proton density fat-suppressed images (a and b) demonstrates ill-defined hyperintense lesion in subcutaneous plane along medial aspect of proximal leg with no extension deep to the deep fascia. The lesion shows few ovoid signals (solid red arrow) with internal hypointense dot – possible “dot-in-circle” sign.
Figure 2
Figure 2
Coronal proton density fat-suppressed images (c) demonstrate ill-defined hyperintense lesion in subcutaneous plane along medial aspect of proximal leg with no extension deep to the deep fascia. The lesion shows few ovoid signals (solid red arrow) with internal hypointense dot – possible “dot-in-circle” sign.
Figure 3
Figure 3
Sagittal proton density fat-suppressed images (d) demonstrate ill-defined hy perintense lesion in subcutaneous plane along medial aspect of proximal leg with no extension deep to the deep fascia. The lesion shows few ovoid signals (solid red arrow) with internal hypointense dot – possible “dot-in-circle” sign.
Figure 4
Figure 4
Excised sample around knee joint showing brown-black granules.
Figure 5
Figure 5
Histopathological examination showing multiple fungal colonies surrounded with inflammatory infiltrates suggestive of Madurella mycetomatis.
See this image and copyright information in PMC

References

    1. Suneet S, Anurag K. Surgical Diseases in Tropical Countries. New Delhi, India: Jaypee Brothers; 1996.
    1. Baki R, Mathur DR. Incidence and changing pattern of Mycetoma in Western Rajasthan. Indian J Pathol Microbiol. 2008;51:154–5. - PubMed
    1. Mahgoob ES. Mycetoma. In: Gurrent RL, Walker DH, Weller PF, editors. Tropical Infectious Diseases:Principles, Pathogens and Practice. 1st ed. New York: Churchill Livingstone; 2000. pp. 616–20.
    1. Welsh O, Vera-Cabrera L, Salinas-Carmona MC. Mycetoma. Clin Dermatol. 2007;25:195–202. - PubMed
    1. Fahal AH. Management of mycetoma. Expert Rev Dermatol. 2010;5:87–93.

Publication types

LinkOut - more resources