Scrotal filariasis in a Caucasian child in Greece

Abstract

Adelais Tzortzopoulou, Panagiota Giamarellou, Aikaterini Michail-Strangia, Alexander Passalides

Lymphatic filariasis is very rare in Greece, despite her geographical position. Only a few cases about affected young men and children have been published during the last century. We report a 2-year-old Caucasian boy presented to our emergency department with a painless swelling in the right scrotum during the last 10 days. Neither fever nor discomfort was reported. In the clinical examination, the right scrotum was hard but painless. An ultrasound and a computed tomography (CT) scan showed a mass (d 2.04 x 1.34x 2.48 cm) in the right epididymis and it was thought to be a solid tumor of epididymis. A decision of an exploratory scrotal surgery was made and a right orchiectomy was performed. The histological examination showed that here were a lot of eosinophil, lymphocytes and some parasites, namely Wuchereria bancrofti in the parenchyma of both testis and epididymis. Then some more specific blood tests were done, which were negative for filariasis, and it was decided that chemotherapy was not needed. In a follow-up period of one and two years after the surgery, all the tests (blood tests and CT scan) were normal and the child had a normal everyday life. Sometimes some clinical cases in children could be tricky. In Europe, such parasitic diseases, as filariasis, are very rare and their diagnosis is difficult for even an experienced pediatric surgeon.