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Figure 5: Complete excision specimen Figure 6: Postoperative photograph after complete healing (three months
after surgery)

Figure 7: Hematoxylin and eosin stain shows variable size spores with
sporangia in the lumen Figure 8: Periodic acid‑Schiff stain highlighting the wall of spores

R. seeberi. Recently, an analysis of the 18S ribosomal canthus. The reasons for the spread of infection are
[1]
ribonucleic acid gene classified it as a protistan parasite unclear, and may occur secondary to local inoculation
and included it in the new class mesomycetozoea. The following trauma which progresses with local replication
[2]
organism is prevalent in Southern India, Sri Lanka and of the organism and associated hyperplastic growth of
Southeast Asia, although cases have been reported host tissue and a localized immune response. Nasal and
in South America, Africa and the United States. The mucosal rhinosporidiosis usually spread by bathing in
most common age group affected is 15‑40 years with a stagnant fresh water of ponds, lakes or rivers whereas
predominance in males. The nose and nasopharynx are ocular rhinosporidiosis spreads by dust or air. In cases in
[5]
affected in 70%, while the palpebral conjunctivae and which only the lacrimal sac is involved, it is believed that
associated structures are affected in 15% of cases. The the infection reaches the sac from the nose or eye via the
[3]
mouth, upper airway and eye may also be the sites of lacrimal canaliculi without affecting the nose or conjunctiva.
disease. Additional sites including the skin, ear, larynx, CT scan and magnetic resonance imaging can help
trachea, bronchi, genitals (vagina, penile urethra or meatus in diagnosis and in determining the extent of disease
and scrotum), and rectum have also been described. [4,5] by giving moderate to intense enhancement in
Deep organ involvement with systemic disease has been contrast studies. However, definitive diagnosis requires
[6]
rarely reported.
microscopy of the biopsy specimen. The oval‑shaped
Rhinosporidiosis typically presents with sessile or sporangia, containing hundreds of endospores, are
pedunculated polyps, which are occasionally surrounded easily identified under the microscope. Fungal stains
by whitish spores. Symptoms will depend upon the site including Gomori methenamine silver, periodic
affected. Nasal symptoms include nasal obstruction, acid‑Schiff and potassium chloride also help in the
postnasal drip and bleeding. Ocular symptoms include diagnosis. Serological tests such as the enzyme‑linked
[7]
redness of conjunctiva, itching, epiphora and photophobia. immunosorbent assay are used for epidemiological studies.
When only the lacrimal sac is affected, it may present as The differential diagnosis includes condyloma accuminata
a small, isolated and nontender swelling over the medial and hemangioma. Although rhinosporidiosis cannot

Plast Aesthet Res || Vol 2 || Issue 6 || Nov 12, 2015 355