[Degenerating neurocysticercosis cysts: differential diagnosis with cerebral metastasis]

Neurocysticercosis is the most common parasitic disease of the central nervous system. It has a worldwide distribution.

We report the case of a 70-year-old woman from Guadeloupe presenting gait abnormalities, impaired ideation, right hemiparesis in a context of weight loss, and fatigue. Blood analyses were normal with neither inflammatory syndrome nor blood hypereosinophilia. Brain computed tomography and magnetic resonance imaging showed hydrocephaly in relation with Sylvius' aqueduc stenosis, and diffuse contrast-enhancing lesions suggesting metastases. Because of clinical symptoms, the patient underwent ventriculostomy; the cerebral spinal fluid examination was normal. Then a frontal biopsy was performed. Histological examination was compatible with neurocysticercosis and confirmed by serology. The patient was successfully treated with albendazole and steroids.

Neurocysticercosis must be considered as a differential diagnosis of cerebral metastasis, especially in patients from endemic countries.