A Case of Intradural-Extramedullary Form of Primary Spinal Cysticercosis Misdiagnosed as an Arachnoid Cyst.
10.3340/jkns.2014.55.4.226
- Author:
Minwook YOO
1
;
Chang Hyun LEE
;
Ki Jeong KIM
;
Hyun Jib KIM
Author Information
1. Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. kijeong@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Neurocysticercosis;
Primary spinal cysticercosis;
Taenia solium
- MeSH:
Adult;
Arachnoid*;
Back Pain;
Cysticercosis*;
Diagnosis;
Diagnosis, Differential;
Enzyme-Linked Immunosorbent Assay;
Follow-Up Studies;
Gadolinium;
Humans;
Low Back Pain;
Magnetic Resonance Imaging;
Neurocysticercosis;
Spine;
Subarachnoid Space;
Taenia solium
- From:Journal of Korean Neurosurgical Society
2014;55(4):226-229
- CountryRepublic of Korea
- Language:English
-
Abstract:
We describe a rare case of intradural-extramedullary primary spinal cysticercosis. A 42-year-old man visited our institute for lower back pain. He denied having consumed raw meet. Magnetic resonance (MR) images revealed an intradural pure cystic mass at the L3-L4 level. A radiologic diagnosis of spinal arachnoid cyst was established. Three years later, he complained of aggravated back pain, and follow-up MR examination showed a markedly expanded cyst, occupying the subarachnoid space from the T11 to the S1 level. L2 hemilaminectomy was performed, and a yellowish infected cyst bulged out through the dural opening. The cyst was removed en bloc. The histopathological findings of the cyst were consistent with parasitic infection. Serum enzyme-linked immunosorbent assay (ELISA) confirmed the presence of spinal cysticercosis. As there was no intracranial lesion, the final diagnosis was primary spinal cysticercosis, which is very rare. MR imaging is a sensitive diagnostic tool for detecting cystic lesions in the spine; however, it is difficult to distinguish cysticercosis from non-infectious cysts such as an arachnoid cyst without using gadolinium enhancement. Clinicians treating spinal cysts with an unusual clinical course should include cysticercosis as a differential diagnosis. We recommend contrast-enhanced MR imaging and serum ELISA in the diagnostic work-up of such cases.
