A 66-year-old male presented with abdominal pain, weight loss, and an abdominal mass, initially suspected to be malignancy. Imaging revealed a large retroperitoneal mass. Biopsy and subsequent culture identified the rare dimorphic fungus Histoplasma duboisii, causing African histoplasmosis. The diagnosis was confirmed by microscopic examination showing large yeast forms and molecular sequencing. This case highlights the importance of considering endemic mycoses, even in non-endemic regions, when patients present with unusual masses or systemic symptoms, especially with a travel history. Early and accurate mycological diagnosis is crucial for appropriate treatment and differentiating from other conditions like cancer.
Key note: Consider rare endemic mycoses in patients with unusual masses and relevant travel history, as timely mycological diagnosis is critical.