[A surgical case of solitary cerebral cysticercosis]

A surgical case of solitary cerebral cysticercosis is presented with a review of the literature. A 41 year-old female was admitted to our institute with generalized convulsion. Physical and neurological findings on admission were unremarkable. CT scan revealed a ring-like enhanced mass with perifocal edema in the right rectal gyrus. On MRI, the cyst wall showed iso-signal intensity on T1 weighted image (T1WI) and was markedly enhanced by gadolinium. The cyst fluid showed low signal intensity on T1WI and high signal intensity on T2-weighted image (T2WI). Obvious perifocal edema was seen on T2WI. Laboratory findings were all normal. The mass was totally removed surgically via the right subfrontal route. It was an extraaxial mass and had no attachment to the dura. Histological examination revealed the presence of the scolex, hooklets, and suckers, characteristic of cysticercus. The patient was administered praziquantel at 1200 mg/day for 3 days after surgery. In this case, Taenia solium could not be found in spite of various examinations and sexual transmission was also denied after interview. One possibility was transmission via fresh vegetables grown with excretal compost contaminated with the eggs of T. solium, as the patient often ate spicy pickles called Kimuchi imported from Korea. Physicians should be aware of the possibility of transmission via contaminated fresh vegetables in patients who have never even been to an endemic area, or who have never eaten raw pork.