[resetnos]

Myiasis is an infestation by fly larvae that feed on living or dead tissue. Chrysomya bezziana, the Old World screwworm, is an obligate parasite whose larvae consume living as well as dead tissue, enlarging wounds as they feed. The fly occurs in tropical and subtropical Africa and Asia. Chronic wounds and poor wound care are risk factors; associated conditions include diabetes, dementia and psychiatric illness. Myiasis in cancerous wounds is very rare.

A case reported in 2009 involved a 65-year-old woman treated in Ahvaz, Iran, with myiasis in a facial squamous cell carcinoma. The cancer had begun as a left-cheek ulcer and spread to the nose, upper lip and sinuses. About 60 larvae were removed individually with forceps, followed by saline irrigation and oral antibiotics. About 10 additional larvae were removed from deeper tissue two days later.

[gatagato]

Chrysomya bezziana infestation in a neglected squamous cell carcinoma on the face

Myiasis in cancerous wounds occurs as a complication of skin cancers. Our patient, a 65-year-old woman, was referred to us with blood-tinged, fetid discharge from an old facial wound along with pain and presence of some live worm-like organisms since three days [Figure - 1 (the one in the OP)].

She was a known case of facial squamous cell carcinoma (SCC). The cancer began as an ulcer on the left cheek, four years ago, gradually increasing in size and spreading to the nose, upper lip, and para nasal sinuses. Histopathologically, the ulcer showed moderately differentiated SCC. The patient did not receive any treatment until two years ago for radiotherapy. She was of lower socioeconomic strata and had not kept her wound covered. Urgent computed tomography scan of the head showed soft tissue mass with irregular and ulcerated surface, involving medial canthus of left orbit and left side of the nose, with destruction of anterior part of maxillary sinus and sphenoid bone, suggesting a soft tissue malignancy. This infestation was managed with manual removal of larvae by forceps, one by one, until no visible larvae were identified. About 60 larvae were found in the facial wound. The larvae were whitish in color and measured 12-15 mm in length. The site of infestation was irrigated with normal saline. Eventually, she was discharged on oral antibiotics. Two days later, approximately ten live larvae were extracted again from deeper tissues of facial wound. A few of them were preserved in ethanol, submitted to the Department of Entomology for identification of its species. The species was confirmed to be Chrysomya bezziana.

http://www.bioline.org.br/request?dv09025
http://www.merckmanuals.com/home/ski...s_myiasis.html
http://en.wikipedia.org/wiki/Chrysomya_bezziana

[CDN]

2.4 MEGATON BOMB NEEDED. We are going to need to vaporize the vapour with this thing! Absolutely HORRID! God yuck!

[murofhsirgo]

Any possibility they ate the cancer and left healthy tissue?

[bileboy]

Originally Posted by murofhsirgo ↗

Any possibility they ate the cancer and left healthy tissue?

That's actually an excellent question. After some thought, I don't believe so as cancerous tissue is normal tissue which has proliferated out of control. I think maggot therapy (which is now an accepted mainstream treatment for debridement) only works on necrotic tissue as the maggots refuse to eat tissue with blood supply. Tumours are usually highly vascular.

[bileboy]

Actually, turns out chrysomya bezziana is very unusual - the fliues eat necrotic tissue and the larvae prefer living tissue, as opposed to the usual order of things.

"The fly feeds on decaying organic matter, while the fly larvae feed on the living tissue of warm-blooded mammals as opposed to necrotic tissue that many other fly larvae feed on".

So perhaps they WERE eating the tumour.

[meh_]

There's few things that make me feel grossed out, this is definitely one of them.

[MesaGrande]

[kellyhound]

suicidal thoughts would come in my mind if i had that

[corpsehands]

Her new name is moldy.