A 55-year-old male from Nepal presented with a progressively enlarging, painless abdominal mass over two years, causing a distended abdomen and mimicking malignancy. Initial imaging showed a large, cystic mass. Fine needle aspiration cytology (FNAC) revealed numerous microfilariae and adult filarial worms, confirming a diagnosis of lymphatic filariasis. The patient was treated with diethylcarbamazine and albendazole, showing good clinical improvement. This case highlights the challenges in diagnosing atypical presentations of endemic diseases, especially when they mimic more severe conditions like cancer, emphasizing the importance of considering parasitic infections in differential diagnoses in endemic regions.
Key note: Lymphatic filariasis can present as a large abdominal mass, mimicking malignancy, necessitating careful diagnostic consideration in endemic areas.