Neurocysticercosis presented as a solitary cystic parenchymal lesion mimicking primary brain tumor: A case report
Introduction: Neurocysticercosis (NCC) is an infection of the central nervous system by the larval stage of pork tapeworm (Taenia solium/T. solium). Diagnosing NCC can be challenging, particularly among those who reside in areas with rare occurrence of NCC and atypical manifestation such as a solita...
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Elsevier
2020-01-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214250920303127 |
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| author | Andreas Soejitno I Wayan Niryana Ni Putu Sriwidyani Ni Made Susilawathi Ni Putu Witari A.A. Raka Sudewi |
| author_facet | Andreas Soejitno I Wayan Niryana Ni Putu Sriwidyani Ni Made Susilawathi Ni Putu Witari A.A. Raka Sudewi |
| author_sort | Andreas Soejitno |
| collection | DOAJ |
| description | Introduction: Neurocysticercosis (NCC) is an infection of the central nervous system by the larval stage of pork tapeworm (Taenia solium/T. solium). Diagnosing NCC can be challenging, particularly among those who reside in areas with rare occurrence of NCC and atypical manifestation such as a solitary parenchymal lesion. We treated a patient whose initially was diagnosed with brain abcess and later, brain tumor, only finally revealed to be an NCC case. Case report: A 25-year old male suffered from multiple focal-to-bilateral tonic clonic seizures, was initially diagnosed as brain abscess. He was given antibiotics and anti-seizure medication but the seizure relapsed with a typical semiology. Physical examination demonstrated grade I papilledema, grade 4+ hemiparesis, and headache of vascular origin. Patient was suspected to have oligodendroglioma after underwent head MRI examination and subsequent tumor resection was performed. Pathological anatomy evaluation demonstrated multiple cystic segments containing larva of tapeworm, supporting a diagnosis of active NCC infection. After 14-day course of antheminthic treatment and resumed AED, patient was seizure-free and NCC was not found upon follow-up CT scan. Conclusion: NCC, with respect to clinical and radiological manifestations, can be protean. A high index of suspicion towards NCC should always be maintained, particularly among patients originated from endemic area. Appropriate treatment with anthelminthic may result in full disease resolution, thus precluding unnecessary invasive approach. |
| first_indexed | 2024-12-16T17:16:08Z |
| format | Article |
| id | doaj.art-7987c930971a493ab2efd7f66071df33 |
| institution | Directory Open Access Journal |
| issn | 2214-2509 |
| language | English |
| last_indexed | 2024-12-16T17:16:08Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj.art-7987c930971a493ab2efd7f66071df332022-12-21T22:23:17ZengElsevierIDCases2214-25092020-01-0122e01004Neurocysticercosis presented as a solitary cystic parenchymal lesion mimicking primary brain tumor: A case reportAndreas Soejitno0I Wayan Niryana1Ni Putu Sriwidyani2Ni Made Susilawathi3Ni Putu Witari4A.A. Raka Sudewi5Departement of Neurology, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, IndonesiaDepartement of Neurosurgery, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, IndonesiaDepartement of Pathological Anatomy, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, IndonesiaDepartement of Neurology, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, Indonesia; Corresponding authors at: Jl. Kesehatan no. 1, Denpasar, 80114, Indonesia.Departement of Neurology, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, IndonesiaDepartement of Neurology, Faculty of Medicine, Udayana University/Sanglah Hospital, Bali, IndonesiaIntroduction: Neurocysticercosis (NCC) is an infection of the central nervous system by the larval stage of pork tapeworm (Taenia solium/T. solium). Diagnosing NCC can be challenging, particularly among those who reside in areas with rare occurrence of NCC and atypical manifestation such as a solitary parenchymal lesion. We treated a patient whose initially was diagnosed with brain abcess and later, brain tumor, only finally revealed to be an NCC case. Case report: A 25-year old male suffered from multiple focal-to-bilateral tonic clonic seizures, was initially diagnosed as brain abscess. He was given antibiotics and anti-seizure medication but the seizure relapsed with a typical semiology. Physical examination demonstrated grade I papilledema, grade 4+ hemiparesis, and headache of vascular origin. Patient was suspected to have oligodendroglioma after underwent head MRI examination and subsequent tumor resection was performed. Pathological anatomy evaluation demonstrated multiple cystic segments containing larva of tapeworm, supporting a diagnosis of active NCC infection. After 14-day course of antheminthic treatment and resumed AED, patient was seizure-free and NCC was not found upon follow-up CT scan. Conclusion: NCC, with respect to clinical and radiological manifestations, can be protean. A high index of suspicion towards NCC should always be maintained, particularly among patients originated from endemic area. Appropriate treatment with anthelminthic may result in full disease resolution, thus precluding unnecessary invasive approach.http://www.sciencedirect.com/science/article/pii/S2214250920303127NeurocysticercosisSolitaryCysticParenchymal lesionTaenia solium |
| spellingShingle | Andreas Soejitno I Wayan Niryana Ni Putu Sriwidyani Ni Made Susilawathi Ni Putu Witari A.A. Raka Sudewi Neurocysticercosis presented as a solitary cystic parenchymal lesion mimicking primary brain tumor: A case report IDCases Neurocysticercosis Solitary Cystic Parenchymal lesion Taenia solium |
| title | Neurocysticercosis presented as a solitary cystic parenchymal lesion mimicking primary brain tumor: A case report |
| title_full | Neurocysticercosis presented as a solitary cystic parenchymal lesion mimicking primary brain tumor: A case report |
| title_fullStr | Neurocysticercosis presented as a solitary cystic parenchymal lesion mimicking primary brain tumor: A case report |
| title_full_unstemmed | Neurocysticercosis presented as a solitary cystic parenchymal lesion mimicking primary brain tumor: A case report |
| title_short | Neurocysticercosis presented as a solitary cystic parenchymal lesion mimicking primary brain tumor: A case report |
| title_sort | neurocysticercosis presented as a solitary cystic parenchymal lesion mimicking primary brain tumor a case report |
| topic | Neurocysticercosis Solitary Cystic Parenchymal lesion Taenia solium |
| url | http://www.sciencedirect.com/science/article/pii/S2214250920303127 |
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