A case of oral dirofilariasis
Human dirofilariasis is a rare helminthic zoonosis caused by a nematode Dirofilaria. Intra-oral dirofilarial infections are extremely uncommon.

A 32-year-old male farmer presented with a painless submucosal mass in his right buccal mucosa since 1-month. Intra-oral examination revealed a solitary, painless, mobile, firm, submucosal nodule measuring about 1 cm × 2 cm located in the right buccal mucosa.

There was no sinus or discharge from the swelling. The overlying mucosa was normal in colour. His medical and family history was non-contributory. A complete haemogram was normal. Differential diagnosis of salivary gland neoplasm, lipoma, neurofibroma, calcified lymph node and infected epidermoid cyst were considered. Since the clinical diagnosis was a soft tissue lesion, a radiograph was not taken.

The lesion was excised under local anaesthesia through intraoral approach. Microscopic examination of the specimen showed a cystic cavity lined by fibrous connective tissue composed of inflamed granulation tissue containing cross-sections of a nematode.

Higher magnification showed a thick-multi-layered cuticle, a central intestinal tube and well-developed somatic musculature. Based on these morphological features, an infection with a D. repens was diagnosed. Patient underwent stool and sputum analysis, which was negative for cysts or ova. The chest radiograph was normal. Patient has remained free of local and systemic disease after 2 years of follow-up.

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