Aspergilloma clinically mimicking Achilles tendon xanthoma in a non-immunocompromised patient: A case report

A 48-year-old woman visited our outpatient clinic complaining of discomfort while wearing shoes due to a large mass around her Achilles tendon. The mass was firm, non-tender, non-reducible, and moved with the Achilles tendon, similar to Achilles tendon xanthoma. However, magnetic resonance imaging revealed multiple heterogeneous, nodular lesions with low T1 and T2 signal intensity, and histological examination of the biopsy specimen revealed the mass to contain hyphae of Aspergillus, indicating aspergilloma. The purpose of this case report is to emphasize that a tumor around the Achilles tendon can be something other than xanthoma even when the clinical features are typical of xanthoma. LEVEL OF CLINICAL EVIDENCE: 4.