MRI Reveals Parasitic Infection Mistaken for Brain Cancer in Spanish Patient
A 60-year-old man from Spain was admitted to hospital after two weeks of worsening headaches and mild behavioral changes. Initial CT scans showed multiple brain lesions that appeared to be metastatic cancer, suggesting the cancer had spread from another organ. However, extensive imaging and tests failed to locate any primary tumor elsewhere in his body. This discrepancy prompted doctors to order a detailed MRI, which revealed the lesions were not cancerous tumors but tiny cysts containing structures typical of tapeworm larvae.
Blood tests confirmed the diagnosis of neurocysticercosis, a parasitic infection of the nervous system caused by the pork tapeworm Taenia solium. Despite its name, the disease usually results from ingesting microscopic tapeworm eggs via contaminated food, water, or hands, rather than eating undercooked pork. The larvae migrate through the bloodstream to organs including the brain, where they form cysts that can cause neurological symptoms.
Neurocysticercosis is a common cause of acquired epilepsy in parts of Asia, Latin America, and Africa but is rare in Europe and Israel. Its brain imaging appearance can mimic cancer, especially when multiple lesions are present. In this case, the absence of a primary tumor led to further MRI evaluation, preventing unnecessary brain biopsy or cancer treatments. The patient was treated with antiparasitic drugs albendazole and praziquantel, along with anti-inflammatory therapy, and recovered without major complications.
The patient had never traveled to endemic regions, leading researchers to speculate he was infected years earlier during construction work through indirect contact with an infected person. Symptoms of neurocysticercosis vary depending on cyst location and number and can include headaches, seizures, dizziness, muscle weakness, speech difficulties, memory loss, behavioral changes, and increased intracranial pressure. Early diagnosis enables effective treatment and reduces risk of serious complications.
This case highlights the importance of considering neurocysticercosis even in non-endemic countries when imaging findings do not align with clinical and laboratory results. It also underscores the value of hygiene practices such as handwashing, thorough washing of fruits and vegetables, and fully cooking meat to prevent parasitic infections. The case demonstrates how advanced diagnostic imaging can shift patient management from aggressive cancer therapies to targeted antiparasitic treatment, leading to recovery.
