Presentation
Headache with 1 episode of seizure
Patient Data
well-defined, peripherally enhancing thick-walled, multicystic lesion (racemose pattern) in the right frontal lobe
the lesion appears as T1 isointense, T2/FLAIR was heterogeneously hyperintense with few cysts showing a hypointense wall, and no blooming on gradient echo. Few of the cysts show central restriction diffusion
largest lesion shows hypointense central dot sign, favoring the diagnosis of NCC
intense perilesional edema causing mass effect on adjacent parenchyma
mid line shift of 3.7 mm to the left
Case Discussion
The above features are likely suggestive of neurocysticercosis (NCC) - colloidal vesicular stage. Typical scolex is seen in the early colloidal stage, but gradually it becomes difficult to identify.
Unfortunately, further clinical or imaging follow-up is not available for this case.
The closest differential is tuberculoma, ruled out due to lack of T2 hypo-intensity and the presence of central necrosis.
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