A worrying dance in the subcutaneous adipose tissue
Abstract
A 37-year-old woman presented to the emergency department with a mild painful swelling in the anterior abdominal wall at the right iliac fossa; there was no associated itching or rash. Five months earlier she underwent right mastectomy for infiltrating ductal carcinoma, which was still under treatment with chemotherapy (doxorubicin, cyclophosphamide, paclitaxel, pertuzumab and trastuzumab). Her vital signs and blood exams were normal. Ultrasonography (US) showed a 8 x 5 mm sized anechoic lesion with multiple internal thin structures, which presented parallel echogenic borders and anechoic centers, in the subcutaneous adipose tissue (Figure 1, red arrow). These structures exhibited wriggling motion during real-time imaging (Video 1).
References
- 1) Momčilović S, Jovanović A, Gasser RB. Human dirofilariasis - A potentially significant nematode zoonosis in an era of climate change. J Infect 2025;90:106460. DOI: https://doi.org/10.1016/j.jinf.2025.106460
- 2) Poggiali E, Dacrema A, Vercelli A. Doctor, something is stuck in my eye! Emerg Care J 2025; https://doi.org/10.4081/ecj.2025.14036. DOI: https://doi.org/10.4081/ecj.2025.14036
- 3) Simón F, Diosdado A, Siles-Lucas M, et al J. Human dirofilariosis in the 21st century: A scoping review of clinical cases reported in the literature. Transbound Emerg Dis 2022;69:2424-39. DOI: https://doi.org/10.1111/tbed.14210
- 4) Harizanov RN, Jordanova DP, Bikov IS. Some aspects of the epidemiology, clinical manifestations, and diagnosis of human dirofilariasis caused by Dirofilaria repens. Parasitol Res 2014;113:1571–9. DOI: https://doi.org/10.1007/s00436-014-3802-3
- 5) Momčilović S, Gabrielli S, Đenić N, et al. New cases of human dirofilariosis on the Balkan Peninsula – "Masked intruders" uncovered by a surgeon. Parasitol Int 2022;86:102482. DOI: https://doi.org/10.1016/j.parint.2021.102482
- 6) Amaral F, Dreyer G, Figueredo-Silva J, et al. Live adult worms detected by ultrasonography in human Bancroftian filariasis. Am J Trop Med Hyg 1994;50:753–7. DOI: https://doi.org/10.4269/ajtmh.1994.50.753
- 7) Joseph M, Krishna MM, Vijayan A. Human Subcutaneous Dirofilariasis. Cureus 2023;15:e35879. DOI: https://doi.org/10.7759/cureus.35879
- 8) Capelli G, Genchi C, Baneth G, et al. Recent advances on Dirofilaria repens in dogs and humans in Europe. Parasit Vectors 2018;11:663. DOI: https://doi.org/10.1186/s13071-018-3205-x
Metrics
Citations and online attention from Dimensions, Altmetric and PlumX.
License
Copyright (c) 2025 the Author(s)

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.