Onchocerciasis is an infection with cutaneous, ocular and systemic manifestations caused by the filarial nematode Onchocerca volvulus, which is transmitted by the bite of various species of the anthropophilic blood-sucking Simulium vectors (black flies). Onchocerciasis is endemic to the savannahs and rainforests of subequatorial Africa and in some countries of the Arabian Peninsula, notably Yemen and Oman, and in Central America, and the Amazon basin of South America. Onchocercomas, which can be defined as subcutaneous fibrous nodules containing adult worms, are among the variable clinical manifestations of this infestation; they are either superficial or deep and usually located over bony prominences. In this paper we report a case of an onchocercoma of the cheek affecting an Iraqi child that was surgically excised. To the best of our knowledge, this is the first case of onchocerciasis in general and onchocercoma in particular that is reported in Iraq with an unusual site, since most of the reported cases occur over bony prominences, and head nodules are reported to occur mostly in the scalp region.
