Subcutaneous zygomycosis masquerading as a soft tissue sarcoma – a case report

Basidiobolus ranarum is a known cause of subcutaneous zygomycosis. The clinical presentation of the subcutaneous disease is quite characteristic. We present the case of painless subcutaneous Zygomycosis involving the right upper arm mimicking soft tissue sarcoma. The fluorescent microscopy with calcofluor white stain showed broad, ribbon-like, relatively aseptate hyphae suggestive of Zygomycetes species. A Lacto Phenol Cotton Blue mount from the culture showed broad hyphae and many asexual spores some of them showing hyphal forms with globose to pyriform shaped conidia of sizes varying from 30-50 μm in diameter. The morphology was characteristic of Basidiobolus ranarum. Patients with Basidiobolomycosis responds well to oral potassium iodide therapy as well to azoles, particularly itraconazole and posaconazole. Patient was treated with oral potassium iodide 40 mg/kg per day for a week with addition of oral itraconazole 100 mg/day and the treatment continued for six months.