Journal List > J Korean Orthop Assoc > v.53(4) > 1100528

Jeong, Lee, Eun, and Byun: Intradural Extramedullary Cysticercosis Involving the Thoracolumbar Spinal Canal in a Patient with Cerebral Cysticercosis

Abstract

Neurocysticercosis (NCC) by Taenia solium is the most common parasitic infection of the central nervous system involving the cerebrum. However, spinal involvement of NCC is rare. Spinal NCC can cause radiculopathy, myelopathy, cauda equina syndrome, and even paraparesis, depending on its location and size. Spinal NCC may require surgical treatment as a first-line treatment because medical therapy can further aggravate the inflammation due to dead cysts, resulting in clinical deterioration. The current standard therapy for spinal NCC is surgical decompression followed by medical therapy. We experienced a case of widespread thoracolumbar intradural extramedullary cysticercosis involving the spinal canal with cerebral cysticercosis. We report this rare case with literature review.

Figures and Tables

Figure 1

(A) Magnetic resonance imaging demonstrated variable sized cystic lesions in the intradural, extramedullary space and a huge, septated cystic lesion with diffuse enhancement and adhesion of arachnoid at the T12–L3 level. (B) Diffuse enhancement and adhesion of arachnoid with empty sac sign (arrows) in the lumbar spine.

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Figure 2

After careful cystic wall incision, clear cystic fluid gushed out, which was sucked using a suction. Multiple small grape-like whitish masses (arrows) within the cyst were found and removed in a piecemeal fashion. Massive irrigation with hypertonic saline was performed.

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Figure 3

Gross specimen shows oval, white, and friable cystic masses that were easily separated from the surrounding arachnoidal adhesions.

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Figure 4

Microscopic view of the specimen taken during the operation (H&E, ×10) showing translucent cyst with eosinophilic lining and clear fluid with chronic inflammatory cells consistent with cysticercosis.

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Notes

CONFLICTS OF INTEREST The authors have nothing to disclose.

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Young-Sang Lee
https://orcid.org/0000-0002-8520-5149

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