gms | German Medical Science

Objective: Neurocysticercosis is the most frequent parasitic disease of the central nervous system worldwide. It is caused by the larval stage of Taenia solium. It usually presents with seizures, headaches, and hydrocephalus. Humans become infected with the metacestode stage (cysticercus) of T. solium after eating uncooked pig meat. We present a case with neurocysticercosis mimicking glioma.

Method: A 44-year-old female presented with headache and seizure. The headache had been present for 6 months and had been getting worse in the last 2 weeks. The patient had an epileptic seizure 2 weeks ago. She did not travel to any foreign countries. On examination, she had no neurologic finding. The MRI disclosed an approximately 7–8 mm solitary cystic lesion with gadolinium enhancement in the peripheral and in the right parietal lobe surrounded by a perifocal edema. Hematologic and biochemical tests gave no pathological results. Despite extensive microbiological examinations, no infectious agents could be detected. Both chest and abdominal CT scans were normal. At surgery a solid, round-shaped lesion with a light-yellow-colored, glossy surface was observed. The patient had an uncomplicated post-operative recovery. Histological examination revealed a scolex of a Taenia solium surrounded by inflammatory chronic granulomatous infiltrates.

Results: Neurocysticercosis was diagnosed with no extraneural involvement. The patient received an antiparasitic treatment with albendazole 800 mg/d in combination with dexamethasone 4 mg every 8 h for 4 weeks and remained seizure-free under anticonvulsant therapy with Levetiracetam 1000 mg/d.

Conclusions: Glioblastoma multiforme (GBM), a frequent malignant glioma in adults, may have similar clinical and neuroimaging presentation as Neurocysticercosis because both diseases can present with parenchymal cysts. Neurocysticercosis should be considered in the differential diagnosis of the solitary brain lesion.