title: Rhinosporidiosis of Parotid Duct Presenting as Consecutive Bilateral Facial Swelling: A Rare Case Report and Literature Review.
abstract: Rhinosporidiosis is a chronic granulomatous infection caused by Rhinosporidium seeberi. Sporadic cases of rhinosporidiosis has been reported from many countries but is endemic in Southern India (Madurai, Ramnad, Rajapalayam and Sivaganga), Nepal, Bangladesh and Sri Lanka. This disease commonly affects the mucous membrane of the nose or naso-pharynx and presents as a leafy, polypoidal mass. The reported extranasal sites include the oro-pharynx, eye, ear, larynx, trachea, bronchi, skin and genital mucosa. It may also become disseminated to present as a generalized form. In our case a 40-year-old female from rural West Bengal (Eastern India) presented with right sided facial swelling. Our provisional diagnosis was parotid duct cyst on the basis of careful history, scrupulous clinical examination and relevant investigations comprising CECT scan of face. Although Rhinosporidiosis was not taken into consideration in the clinical differential diagnosis, it was eventually diagnosed postoperatively by histopathological examination of surgical specimen. Two months later in follow-up, the same patient presented to us with left sided facial swelling. We managed the left facial swelling successfully with minimally invasive surgery and 100mg twice daily dapsone for 6 months. We present this case firstly because Rhinosporidiosis of parotid duct (stensen's duct) is a rare entity and secondly non-neoplastic cysts of the salivary glands are also uncommon and represent only 2-5% of all salivary gland lesions. Furthermore our case emphasizes that the clinicians should aware of this rare clinical entity specially in endemic areas, because minimally invasive techniques and medications might solve the problem while helping patients to avoid surgical excision.
authors.affiliation: Assistant Professor, Department of General Surgery, Burdwan Medical College & Hospital , West Bengal, India .
authors.forename: Santanu
authors.initials: S
authors.lastname: Sarkar
authors.affiliation: PG Resident, Department of General Surgery, Burdwan Medical College & Hospital , West Bengal, India .
authors.forename: Soumyajyoti
authors.initials: S
authors.lastname: Panja
authors.affiliation: Assistant Professor, Department of Pathology, Burdwan Medical College & Hospital , West Bengal, India .
authors.forename: Arghya
authors.initials: A
authors.lastname: Bandyopadhyay
authors.affiliation: Demonstrator, Department of Pathology, Burdwan Medical College & Hospital , West Bengal, India .
authors.forename: Shreosee
authors.initials: S
authors.lastname: Roy
authors.affiliation: PG Resident, Department of General Surgery, Burdwan Medical College & Hospital , West Bengal, India .
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kumar
keywords: Dapsone; Mesomycetozoea; Minimally invasive surgery; Stensen’s duct cyst