Disseminated Cutaneous Rhinosporidiosis: a Tumor like Lesion with Therapeutic Challenge

Rhinosporidiosis is a granulomatous disorder caused by Rhinosporidium seeberi, an aquatic parasite. It spreads through contaminated water and soil. It frequently involves the nasal cavity and nasopharynx. Disseminated or systemic lesions are rare. A 56 year old man presented with multiple tumor like lesions all over the body in our cancer institute in April 2012. Fine needle aspiration cytology (FNAC) from the skin lesions revealed many sporangia and spores of R. seeberi. He had history of nasal mass being removed by excision and was immunocompetent. Histopathological examination and periodic acid Schiff (PAS) stain confirmed it to be disseminated rhinosporidiosis. His accessible lesions were excised with cautery and he was put on oral dapsone therapy. He did not show recurrence till six months of therapy. A common lesion with an uncommon presentation should not be missed which can increase the morbidity and even mortality in such a case.