Journal
CLINICAL INFECTIOUS DISEASES
Volume 60, Issue 10, Pages 1500-1504Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/civ104
Keywords
chromoblastomycosis; squamous cell; carcinoma; melanized fungi; Fonsecaea spp
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Funding
- FAPEMIG (Fundacao de Amparo a Pesquisa do Estado de Minas Gerais)
- CNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico)
- CAPES (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior)
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Background. Chromoblastomycosis (CBM) is a chronic fungal infection caused mainly by the melanized fungi Fonsecaea species. The chronic lesions may be predisposed to develop into cancer, the most serious complication of the disease. Methods. In this report, 7 cases of squamous cell carcinoma (SCC) resulting from chronic CBM in patients from Maranhao in the Brazilian Amazon are described. Results. The 7 patients presented with SCC that resulted from chronic CBM, caused by Fonsecaea species >10 years' duration. The malignant lesions occurred independent of the antifungal therapy and all patients underwent curative amputation, except for 1 patient who developed metastases in the inguinal and intra-abdominal lymph nodes and thigh muscles. A majority of previous reports have focused on the malignant transformation of CBM described in only 1 patient each. This is a first report describing a group of patients from a single Brazilian state. Conclusions. Here, we provide new epidemiologic data on malignant CBM lesions, an endemic disease that is seemingly neglected worldwide. We reinforce the idea that typically chronic lesions may be predisposed to turn malignant.
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