Myospherulosis was first described in 1969 Africa by McClatchie et al[1
]. The name was used based on the suspicion that this might be a curious new fungal infection. It is now known that these structures represent altered erythrocytes. In the first case described in Kenya, the myospherules were round bags of spherules surrounded by a thin, somewhat refractile membrane under light microscopy[1
]. The spherules were said to be slightly larger than red blood cells and closely & irregularly packed together. No obvious internal structure was seen, but in some there were small granules or irregular blebs of eosinophilic material[1
]. They were located within cysts surrounded by fibrous tissue, histiocytes, and giant cells[1
]. Some of the myospherules were ingested by giant cells in the cyst wall.[3
Myospherulosis can occur in various sites in the body such as muscle, bone, kidneys, liver, retroperitoneum, brain.[3
] In our case it has involved retroperitoneum, ileum and gluteal region.
The cases reported so far in the literature can be divided into 2 categories: those iatrogenic cases where causality with petroleum-based ointment and gauze packs could be found,[3
] such as those seen in the paranasal cavity,[4
] ocular cavity,[5
] and in dermal tissue, and second categories are those cases where erythrocytes are altered by endogenous fat or lipids.[3
] Examples include cases found in subcutaneous tissue, breast tissue, perirenal adipose tissue,’ steatocystoma[2
], and an adjacent benign cystic teratoma.[3
Myospherulosis presentation can very according to the location. In the brain it may present like that of a brain tumour.[3
] In our case patient had presented with local pain, mass and sciatica which is classical presentation of sacral plexus and sciatic nerve tumor. Preoperative FNAC reported schwannoma and radio-imaging also suggested a dumble shaped nerve tumour. Even though histopathology surprised us, per operatively we found only fibrotic attachment with the sciatic nerve in lower gluteal region. In this case, pain might be from pressure over sacral plexus and/ or attachment & pressure on sciatic nerve. In such a case, surgical excision is all that needed.