Maduramycosis masquerading malignancy: A case report from rural oncology center

Mycetoma is a chronic granulomatous inflammation of the dermis and epidermis caused by filamentous bacteria in 60% of cases (actinomycetoma) or fungi (eumycetoma) in 40% of cases. A 45-year-old female presented with a left foot ulcer and gradually increasing swelling for 13 years in our department. The radiograph revealed multiple punch-out lytic areas in the tarsals with sclerosis and destruction of the calcaneum. The characteristic “dotin-circle” sign was appreciated on both ultrasound and magnetic resonance imaging. The causative organism and the radiological evaluation, especially bone involvement, are the most important factors that determine the choice of treatment. In the initial stages, chemotherapeutic drugs along with surgery are effective. The current concept is with treatment with a combination of drugs under the name of Welsh regimen.