A case of solitary cerebral cysticercosis

Abstract

A case of solitary cerebral cysticercosis is reported. The patient, a 46-year-old man complaining of head dullness, had been in Manila, the Philippines a month before his admission to Kitasato University Hospital. MRI and CT scans showed a small solitary cystic lesion in the left temporal lobe which was located at the cerebral surface. His neurology and blood/stool tests were within the normal range. A well circumscribed encapsulated cyst of about 1 cm in diameter was surgically resected. Histologically, the lesion was consistent with cysticercus of Taenia solium having a scolex with hooklets and suckers. As the patient had no prior history of discharging worm segments in his stool, and as he has displayed no other abnormalities, we surmise that he was freshly recently infected, having ingested an egg of the worm with fresh vegetables. Reviewing the literature, the cases of solitary cerebral cysticercosis seem to be the increasing in Japan recently. It may be due to an increase in the number of Japanese travelers to other countries or it may also be due to the increased import of fresh vegetables from contaminated countries. Therefore, solitary single cysticercosis should be included in the differential diagnosis of a cystic lesion in the brain.