Clinical decision-making in gastric taeniasis: risks of endoscopic removal and role of staged therapy

This case describes a rare presentation of gastric taeniasis in a young woman with chronic atrophic gastritis and subcutaneous lesions consistent with cysticercosis. Stool microscopy confirmed Taenia spp eggs, though species identification was limited by the absence of morphological or molecular confirmation. While clinical evidence strongly suggested Taenia solium, this limitation is acknowledged. The case underscores the importance of clinical judgement in avoiding endoscopic removal, given risks of incomplete extraction, rupture and anaphylaxis. A staged pharmacologic regimen was employed: niclosamide with purgation achieved intestinal clearance, followed by albendazole for tissue infection. This strategy led to complete symptom resolution and regression of nodules. Corticosteroids were unnecessary, as neurocysticercosis and ocular involvement were excluded. The report emphasises prioritising medical therapy over endoscopic intervention and highlights the relevance of dietary history in endemic regions, where consumption of raw or undercooked pork remains a major exposure risk.