Title : Atypical clinicoradiological findings in cases of cerebral neuroschistosomiasis: a case series and literature review
Abstract:
Cerebral schistosomiasis (CS) is a rare, severe ectopic manifestation of Schistosoma infection, with Schistosoma japonicum exhibiting a strong predilection for cerebral parenchyma. Its presentation as a solitary pseudotumoral mass frequently mimics primary glial neoplasms such as high-grade gliomas, creating significant diagnostic dilemmas and risking unnecessary or delayed targeted treatment. We report two cases of young Filipinos from the province of Leyte presenting with an insidious history of headache, and seizures, with Cranial Magnetic Resonance Imaging (MRI) findings suggestive of high grade glioma. Further diagnostic work up, however, established the diagnosis of CS. Both cases had favorable outcomes after one case underwent surgical intervention while the other one was optimized medically with praziquantel and steroids alone. High index of suspicion coupled with comprehensive clinical history, specific diagnostics, and multidisciplinary discussions can lead to more accurate diagnosis and prompt treatment of CS.
