{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T10:45:54Z","timestamp":1761907554055,"version":"build-2065373602"},"reference-count":15,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,10,18]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>\n                    Mycetoma is a chronic, granulomatous infection typically affecting the lower limbs. We report a rare case of eumycetoma involving the upper back in a young man with a 10-year history of painless swelling that became symptomatic only recently. After initially diagnosed as an abscess, intraoperative discovery of black granules prompted further investigation. Histopathology confirmed\n                    <jats:italic>Madurella mycetomatis<\/jats:italic>\n                    infection. Imaging revealed a large heterogeneous mass without bone involvement. The patient underwent complete surgical excision followed by oral itraconazole therapy. At 1\u2009month follow-up, postoperative recovery was uneventful, without recurrence. This case highlights the importance of involving mycetoma in the differential diagnosis of chronic soft tissue swellings, even in rare anatomical sites. Early suspicion, tissue biopsy and MRI are the determinants of accurate diagnosis. Public and clinician awareness is vital, particularly in endemic areas, to prevent misdiagnosis and reduce morbidity. To our knowledge, this is among the few documented cases of extrapedal eumycetoma.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-268543","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T10:40:24Z","timestamp":1761907224000},"page":"e268543","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mycetoma of the upper back: an unusual presentation of a neglected tropical disease"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6015-4015","authenticated-orcid":false,"given":"Mohammed Elamin Elsidig Mohammed","family":"Elsirag","sequence":"first","affiliation":[{"name":"Prince Mutaib Hosptial, Saudi Arabia Ministry of Health, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelazim","family":"H.Mustafa","sequence":"additional","affiliation":[{"name":"General Surgery Department, Al-Jouf Health Cluster, Sakaka, Al-Jouf, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2606-0586","authenticated-orcid":false,"given":"Elfatih Elsiddig","family":"Hagelamin","sequence":"additional","affiliation":[{"name":"Internal Medicine, Al-Jouf Health Cluster, Sakaka, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2411-2066","authenticated-orcid":false,"given":"Nadir","family":"Nasraldeen","sequence":"additional","affiliation":[{"name":"General Surgery, Al-Jouf Health Cluster, Sakaka, Al-Jouf, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9771-3740","authenticated-orcid":false,"given":"Azhari Ibrahim","family":"Dafaallah","sequence":"additional","affiliation":[{"name":"General Surgery, Saudi Arabia Ministry of Health, Sakaka, Al-Jouf, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0500-5465","authenticated-orcid":false,"given":"Almoez ldenalla Salah Alden","family":"Mahjub","sequence":"additional","affiliation":[{"name":"General Surgery, Prince Mutaib bin Abdulaziz Hospital, Sakaka, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1196-482X","authenticated-orcid":false,"given":"Mahir","family":"Khiralla","sequence":"additional","affiliation":[{"name":"General Surgery, Prince Mutaib bin Abdulaziz Hospital, Sakaka, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaser","family":"Taha","sequence":"additional","affiliation":[{"name":"General Surgery Department, Al-Jouf Health Cluster, Sakaka, Al-Jouf, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"2025103103401603000_18.10.e268543.1","doi-asserted-by":"crossref","DOI":"10.3390\/tropicalmed3030097","article-title":"Mycetoma: The Spectrum of Clinical Presentation","volume":"3","author":"Fahal","year":"2018","journal-title":"Trop Med Infect Dis"},{"key":"2025103103401603000_18.10.e268543.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002550","article-title":"Global Burden of Human Mycetoma: A Systematic Review and Meta-analysis","volume":"7","author":"van de Sande","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"key":"2025103103401603000_18.10.e268543.3","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13008"},{"key":"2025103103401603000_18.10.e268543.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(04)01131-4"},{"key":"2025103103401603000_18.10.e268543.5","doi-asserted-by":"crossref","unstructured":"Vera-Cabrera L , Garza JA . Mycetoma. In: Skin disease in travelers. Cham: Springer International Publishing, 2024: 89\u201397.","DOI":"10.1007\/978-3-031-57836-6_11"},{"key":"2025103103401603000_18.10.e268543.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0011841","article-title":"Epidemiological observations and management challenges in extrapedal mycetoma: A three-decade review of 420 cases","volume":"18","author":"Alhaj","year":"2024","journal-title":"PLoS Negl Trop Dis"},{"key":"2025103103401603000_18.10.e268543.7","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800840824"},{"key":"2025103103401603000_18.10.e268543.8","first-page":"193","article-title":"The dot-in-circle sign of mycetoma on MRI","volume":"13","author":"Kumar","year":"2007","journal-title":"Diagn Interv Radiol"},{"key":"2025103103401603000_18.10.e268543.9","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.178.3.1994434"},{"key":"2025103103401603000_18.10.e268543.10","first-page":"1","article-title":"Histopathological approach in diagnosis of mycetoma causative agents: a mini review","volume":"8","author":"Siddig","year":"2017","journal-title":"J Cytol Histol"},{"key":"2025103103401603000_18.10.e268543.11","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/trstmh\/trac069","article-title":"Mycetoma management and clinical outcomes: the Mycetoma Research Center experience","volume":"117","author":"Musa","year":"2023","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2025103103401603000_18.10.e268543.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004690","article-title":"The Surgical Treatment of Mycetoma","volume":"10","author":"Suleiman","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"2025103103401603000_18.10.e268543.13","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200607050-00005"},{"key":"2025103103401603000_18.10.e268543.14","unstructured":"World Health Organization . WHO guidelines for the diagnosis and treatment of mycetoma. Geneva WHO; 2016."},{"key":"2025103103401603000_18.10.e268543.15","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00359-X"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268543","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T10:40:27Z","timestamp":1761907227000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268543"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":15,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,31]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/bcr-2025-268543"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268543","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}