Suprasellar cysticercosis cyst with optic nerve compression masquerading as an arachnoid cyst

• Published in: Middle East African journal of ophthalmology Vol. 26; no. 2; pp. 114 - 116
• Main Authors: Musara, Aaron, Soko, Nyarai, Shamu, Sharai
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.04.2019; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow
• Subjects: Adult; Albendazole - therapeutic use; Animals; Anthelmintics - therapeutic use; Arachnoid Cysts - diagnosis; Arachnoid Cysts - drug therapy; Arachnoid Cysts - parasitology; Brain diseases; Case Report; Cysticercosis; Cysticercosis - diagnosis; Cysticercosis - drug therapy; Cysticercosis - parasitology; Cysticercus - isolation & purification; Cysts; Diagnosis, Differential; Diagnostic imaging; Dosage and administration; Drug Therapy, Combination; Ganglion cells; Ganglion cysts; Headache; Humans; Infection; Infections; Magnetic Resonance Imaging; Male; Medical research; Nerve compression syndromes; Nerve Compression Syndromes - diagnosis; Nerve Compression Syndromes - drug therapy; Nerve Compression Syndromes - parasitology; Nervous system; NMR; Nuclear magnetic resonance; Optic nerve; Optic Nerve Diseases - diagnosis; Optic Nerve Diseases - drug therapy; Optic Nerve Diseases - parasitology; Parasitic diseases; Praziquantel; Praziquantel - therapeutic use; Retina; Taenia solium - isolation & purification; Tomography; Zimbabwe; Africa; arachnoid cyst; Zimbabwe; cysticercosis; optic nerve; Africa
• ISSN: 0974-9233; 0975-1599; 0975-1599; 0974-9233
• DOI: 10.4103/meajo.MEAJO_142_18

Cysticercosis is a parasitic infection caused by the larvae of the cestode Taenia solium. Ocular parasitosis in humans is well recognized; however, cysticercosis of the optic nerve is rare. Here, we report a case of an adult male who presented with right-sided headache and a gradual loss of vision in the right eye. Optical coherence tomography indicated severe loss of ganglion cells in the right eye. Magnetic resonance imaging showed a predominantly suprasellar cystic lesion thought to represent an arachnoid cyst. We performed a craniotomy to excise the cyst. Histopathological examination of the excised cyst revealed internal living larvae of T. soilum. After co-administration of praziquantel and albendazole, vision was restored, and the headaches ceased. Vision has since been restored in both eyes. A higher degree of neurocysticercosis suspicion should be maintained for patients living in endemic areas who present with ophthalmic symptoms where the brain scans show cystic lesions.