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Sparganosis existed for more than three years that misdiagnosed as a breast cancer

3년이상 존재한 유방암으로 의심되었던 스파르가눔증

  • Won, Tae Wan (Department of Surgery, Wonkwang University School of Medicine)
  • 원태완 (원광대학교 의과대학 외과학교실)
  • Received : 2015.07.13
  • Accepted : 2015.08.06
  • Published : 2015.08.31

Abstract

Objective.: Sparganosis locations in humans are usually presented with a subcutaneous tissue of abdominal wall, chest, abdominal vicera and brain, but are rarely found in the breast. Methods. A case of sparganosis was confirmed by surgical excision of two parasites in a 76-year-old female patient present to a palpable mass in the right breast (presumed to have been sparganosis approximately 3 years ago). She had no history to direct ingestion of snakes or frogs, but had the history of drinking contaminated water. Mammography, ultrasonography, MRI, and FDG PET/CT imaging findings for patient were characteristic of sparganosis due to suspicion of breast cancer. Conclusions: The first route of infection in humans is drinking contaminated water. The second route is the ingestion of raw or partially cooked snakes or frogs. The third route is infected wound snake, frog muscle that attach to the case. However, only a few cases of drinking contaminated water have been reported in the country. Ultrasonography, MRI is known to be helpful for diagnosis of breast sparganosis. However, Mammography, ultrasonography, MRI, and FDG PET/CT for breast sparganosis is not reported present in the country. Reported the case and reviewed the related literature briefly.

서론: 인체 스파르가눔은 드물며, 기생부위는 일정치 않으나 주로 흉벽, 복벽, 대퇴 및 음낭 등의 피하조직 및 근육 사이 근막이며 그 외 안와, 흉강, 복강, 척수강 및 중추신경계에서 발생하기도 한다. 이중 유방 스파르가눔증은 드물다. 대상 및 방법: 저자는 76세의 여자 환자에서 감염된 물을 통해 생긴 3년 이상 유방에 움직이며 머무른 것으로 보이는 두 곳의 유방 스파르가눔증을 경험하였다. 환자는 뱀, 개구리 등을 생식하는 과거력은 없었으나 평소 약수를 즐겨마셨다. 유방암으로 오인하여, 이 유방 스파르가눔증에 대해 유방촬영술, 유방초음파, MRI, PDG PET/CT 등을 시행하였고, 외과적 절제술 시행하여 치료하였다. 결론: 인체 감염 경로는 크게 3 가지로, 첫째, 오염된 물을 섭취하는 경우, 둘째, 뱀, 개구리 등을 생식하는 경우, 셋째, 환부에 감염된 뱀, 개구리 근육을 부착하는 경우로, 이중 물에 의한 감염 보고는 국내에 거의 없다. 유방 스파르가눔증에 대해 유방초음파, MRI가 도움이 되는 것으로 알려져 있으나, 하나의 병변에 대해 유방촬영술, 유방초음파, MRI, FDG PET/CT 모두를 보고한 것은 현재 없다. 이에 병리 검사 결과, 영상결과와 더불어 관련된 문헌 고찰과 함께 알아보고자 한다.

Keywords

References

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