Presentation
Headache with left side weakness.
Patient Data
A well-defined cystic lesion with irregular borders and a thin wall with intermittent calcification with internal septations is seen in the temporal and parietal lobes on the right. It exerts mild mass effect seen as compression of the right lateral ventricle with midline shift to the left. There is associated adjacent edema. Post-contrast no sizable enhancing solid component. No abnormal enhancement
A right temporal craniotomy, with postoperative change and a peripheral collection within the operative cavity with surrounded vasogenic edema no significant mass effect or midline shift structure. No residual partially calcified cystic lesion.
Case Discussion
The differential diagnosis of brain cystic appearing lesion with calcification in the brain includes an epidermoid cyst, (although calcification is uncommon), cerebral metastasis, oligodendroglioma (this degree of cystic change would be unusual) and infections including neurocysticercosis (usually smaller).
Neurocysticercosis is unusual in Yemen, and our patient has no history of travel to endemic contraries with cysticercosis.
The patient went on to have a resection.
Histology
After surgical removal of the cyst histopathology reveals cystic contains a larva composed of duct-like invagination lined by double layered eosinophilic membrane reflecting neurocysticercosis.
Acknowledgments: Dr Abdulatif Magram (radiology specialist) and Dr Wael Al-Absi (pathology specialist)
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