Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Ileocecal basidiobolomycosis mimicking malignancy successfully treated without surgery: A case report
Mohammed Saud Alsulaimi, Muhammed Yousuf Memon, Iman M Alyabary, Eman Almotairi, Tareq Sulaiman, Amal N Shamsan, Muhammed Mubarak
Mohammed Saud Alsulaimi, Muhammed Yousuf Memon, Department of Gastroenterology, King Saud Hospital, Unaizah 56437, Al Qassim, Saudi Arabia
Iman M Alyabary, Department of Histopathology, King Saud Hospital, Unaizah 56437, Al Qassim, Saudi Arabia
Eman Almotairi, Department of Surgical Oncology, King Fahad Medical City, Riyadh 12231, Riyadh, Saudi Arabia
Tareq Sulaiman, Department of Internal Medicine, King Fahad Medical City, Riyadh 12231, Riyadh, Saudi Arabia
Amal N Shamsan, Department of Gastroenterology, King Fahad Specialist Hospital, Buraidah 52366, Al-Qassim, Saudi Arabia
Muhammed Mubarak, Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Co-corresponding authors: Muhammed Yousuf Memon and Muhammed Mubarak.
Author contributions: Alsulaimi MS, Memon MY, and Alyabary IM contributed equally to the conception and study design. Alsulaimi MS, Memon MY, Alyabary IM, Almotairi E, Sulaiman T, and Shamsan AN performed relevant research and participated in primary and final drafting. Furthermore, Alyabary IM contributed to histopathological diagnosis, Almotairi E contributed to the surgical review of the patient and Sulaiman T played a role as Infectious Consultant in this case. Alsulaimi MS and Mubarak M critically reviewed and approved the final manuscript. All authors have read and approved the final manuscript. Memon MY and Mubarak M are designated as co-corresponding authors to facilitate collaboration between teams in Saudi Arabia and Pakistan. Memon MY collected comprehensive clinical data, integrated it with laboratory and histopathology findings, and contributed significantly to the drafting of the case presentation and discussion. He conducted an extensive literature review to identify similar reported cases and relevant guidelines, ensuring the discussion section was well-grounded in current evidence. Memon MY also prepared and drew the illustrative figures for the manuscript, enhancing the visual clarity of the clinical and diagnostic aspects. Mubarak M also oversaw project administration on the Pakistani side, maintained correspondence with the journal, and provided guidance during the manuscript’s revision and finalization stages after reviewing it critically.
Informed consent statement: Written informed consent was obtained from the patient to publish this case report.
Conflict-of-interest statement: All authors declared that there is no conflict of interest related to this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Muhammed Mubarak, Department of Histopathology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Sindh, Pakistan.
drmubaraksiut@yahoo.com
Received: April 17, 2025
Revised: July 5, 2025
Accepted: August 15, 2025
Published online: October 26, 2025
Processing time: 177 Days and 15.9 Hours
BACKGROUND
Basidiobolomycosis, a fungal infection affecting immunocompetent individuals, is caused by Basidiobolus ranarum, a fungus classified under the order Entomophthorales, which was previously grouped under Zygomycetes. Gastrointestinal basidiobolomycosis (GIB) is often life-threatening, with a high mortality rate if left untreated; however, favorable outcomes have been achieved with prompt diagnosis and proper management.
CASE SUMMARY
Herein, we present a case of GIB in a 32-year-old Saudi male, and smoker who presented with a 2-month history of mild-to-moderate pain in the right lower quadrant of the abdomen. On clinical suspicion of colon cancer due to the presence of an ileocecal mass on imaging studies, he underwent a colonoscopy and endoscopic biopsy followed by histopathological examination. The latter revealed colonic mucosal fragments showing ulceration, granulation tissue, and marked eosinophilic as well as mixed inflammatory cell infiltration along with scattered giant cells. A few scattered, thin-walled, broad fungal hyphae were evident on special stains. Based on the histopathological findings, the patient was diagnosed with GIB. He was started on voriconazole, but switched to posaconazole after 5 weeks because the patient developed hepatotoxicity. After about 4 months of treatment with posaconazole, he was asymptomatic, and abdominal CT revealed complete resolution of the mass lesion.
CONCLUSION
This case highlights the rare presentation of GIB in an immunocompetent adult initially misdiagnosed as colon cancer, emphasizing the importance of histopathological evaluation in diagnosing fungal infections. It also underscores successful treatment with posaconazole following voriconazole-induced hepatotoxicity, demonstrating therapeutic flexibility in managing GIB.
Core Tip: Gastrointestinal basidiobolomycosis (GIB) is a rare but potentially fatal fungal infection affecting immunocompetent individuals, often mimicking malignancy. This case highlights a 32-year-old Saudi male presenting with right lower quadrant abdominal pain and an ileocecal mass, initially suspected as colon cancer. Colonoscopy and histopathology confirmed GIB, revealing fungal hyphae, eosinophilic infiltration, and granulomatous inflammation. Voriconazole therapy induced hepatotoxicity, necessitating a switch to posaconazole. The patient achieved full clinical and radiological resolution after four months. Early recognition and targeted antifungal therapy are essential for favorable outcomes. This case underscores the importance of considering GIB in the differential diagnoses of abdominal masses in endemic regions.
