Presentation
Left distal medial arm nodule for the last two weeks. Local pain and skin redness. No prior trauma/ local surgery.
Patient Data
A small nodule is visible on the medial arm region. Some skin discoloration. No obvious punctum (black dot) on closer inspection. On palpation, it was mobile favoring the subcutaneous plane. Mild tenderness.
A lesion in the subcutaneous plane measuring 15 (length) x 10 (width) x 10 (thickness) mm. Hypoechoic wall with a thickness of 2 to 3 mm. The central cystic area contains a tubular serpiginous structure which shows parallel echogenic thin walls and an anechoic lumen. No movement of this serpiginous structure. The lesion shows wall irregularity with increased echogenicity of the adjacent subcutaneous fat along with hypervascularity. No vascularity in the central cystic area/ serpiginous structure. No extension deep to the fascia. Patent adjacent subcutaneous basilic vein and deeper brachial artery.
Case Discussion
Findings favor subcutaneous dirofilariasis with dead warm and perilesional inflammation.
A companian case with live warm: https://doi.org/10.53347/rID-68780
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