Huge hemispheric intraparenchymal cyst caused by Taenia multiceps in a child

Case report

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✓The authors report an unusual case of a huge intraparenchymal cyst in a 4-year-old girl caused by Taenia multiceps infection. After surgical removal of the cyst, the child recovered completely. Brain infestation by coenurus is a rare disease, mainly reported in Africa, with a few case reports from patients in developed countries. Humans, especially young children, become intermediate hosts by ingesting eggs passed in the excrement of a definitive host, usually carnivores. In such cases, high mortality and morbidity rates have been reported. These rates decreased after the introduction of the modern neuroradiological techniques of computed tomography and magnetic resonance imaging.

Abbreviations used in this paper: CSF = cerebrospinal fluid; CT = computed tomography; ICP = intracranial pressure; MR = magnetic resonance.

Article Information

Address correspondence to: Mony Benifla, M.D., Department of Neurosurgery, Soroka University, Medical Center, Beer Sheva, Israel. email: moni@bgu.ac.il.

© AANS, except where prohibited by US copyright law.

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Figures

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    Neuroimages obtained in a 4-year-old girl showing a septated cyst. Left: Axial T-2 weighted fluid attenuated inversion recovery image shows the cyst surrounded by minimal vasogenic edema. Right: Coronal T-1 weighted image after gadolinium administration shows a huge septated cyst with minimal enhancement in the medial aspect of the wall and significant mass effect.

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    Macroscopic view of the outer capsule of the cyst, approximately 10 cm in diameter, which resembles the features of a chronic brain abscess. Histologically, the wall is composed of collagen, inflammatory infiltrate, and reactive glial cells (gliosis).

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    Macroscopic view of the inner cyst, approximately 6 to 7 cm in diameter, which was floating inside the outer capsule (Fig. 2). The cystic wall is thin, transparent, and white. The protoscolices (arrows) are clumped on the inner surface.

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    Photomicrograph of a section of a protoscolix of coenurus showing the main anatomical details. Two of four suction cups are present in this section. The protoscolices develop from invaginations of the cystic wall (germinative layer). H & E, original magnification × 400.

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    Axial T2-weighted fluid attenuated inversion recovery image obtained 2 months postoperatively shows complete resection of the lesion with minimal gliosis in the cyst cavity.

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