Title : Solitary neurocysticercosis mimicking a parietal brain tumour in a young woman: A diagnostic challenge
Abstract:
A 24-year-old previously healthy woman presented with a one -week history of severe, sharp right occipital headache (pain score 9-10/10). There were no visual, auditory, or focal neurological symptoms, and no history of trauma or systemic illness. Neurological and systemic examinations were unremarkable, with full motor strength and intact cranial nerves.
Initial CT imaging revealed a right parietal lesion with surrounding oedema. Subsequent MRI demonstrated a solitary 11 « 13 mm rim-enhancing lesion in the right parietal lobe with vasogenic oedema. Further investigations excluded arteriovenous malformation and neoplastic processes. The case was reviewed by a multidisciplinary team, and corticosteroid therapy was initiated to reduce oedema, resulting in marked symptomatic improvement.
Follow-up imaging described the lesion as non-inflammatory, with features suggestive of either a cavemoma or neurocysticercosis (NCC). The patient was referred to a tertiary centre for further evaluation, where serological testing confirmed Tren1s soliuzn infection. Targeted antiparasitic therapy was commenced, leading to clinical improvement.
This case underscores the diagnostic challenge posed by solitary enhancing brain lesions and highlights the importance of considering neurocysticercosis in the differential diagnosis, even in patients without an endemic exposure history.
