article · International Journal of Surgery Case Reports
Extraneural cysticercosis, caused by the larval stage of the parasite Taenia solium, presents significant diagnostic challenges in endemic areas such as sub-Saharan Africa. The infection frequently manifests as a non-specific, solitary soft-tissue mass that mimics benign tumours, frequently causing delays in proper management. Two documented cases from western Uganda illustrate this varied clinical presentation across distinct age groups: a six-year-old child presenting with an acute abdominal muscle mass, and a sixty-five-year-old patient with a subcutaneous chest wall mass persisting for seven years. Both conditions closely resembled benign tumours upon clinical assessment. In both instances, complete surgical excision proved curative. Definitive diagnoses were established via histopathological examination, which identified the parasite. These findings confirm the value of histopathology as an essential diagnostic tool in resource-limited settings.
Extraneural cysticercosis can easily be misdiagnosed as a tumour, leading to delayed or inappropriate clinical interventions. By showing how the parasite manifests in both paediatric and elderly patients with vastly different symptom timelines, these findings help clinicians in endemic regions consider parasitic causes for unexplained swellings. This highlights the vital need for robust basic pathology services where advanced diagnostic equipment is unavailable.
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Introduction and importance: Extraneural cysticercosis (ECC), caused by the larval stage of Taenia solium , is a major diagnostic challenge in endemic regions such as sub-Saharan Africa. ECC frequently presents as a nonspecific, solitary soft-tissue mass, easily mimicking benign tumors and leading to delayed management. This case series highlights the varied clinical spectrum of ECC in western Uganda, following the SCARE criteria. Case presentation: We report two clinically distinct cases of ECC at demographic extremes: a 6-year-old male with an acute intramuscular mass in the rectus abdominis, and a 65-year-old female with a 7-year history of a subcutaneous chest wall mass, both of which were clinically indistinguishable from benign tumors. Definitive diagnoses were established in both cases by histopathological examination of surgically excised specimens, which revealed the characteristic Cysticercus cellulosae scolex. Complete surgical excision was curative. Clinical discussion: These cases underscore the diagnostic difficulty of ECC across disparate age groups (pediatric and elderly) and varying chronicity (2 weeks vs. 7 years). The first case highlighted the risk of systemic dissemination; the second demonstrated the fibrotic burnout stage. Both cases confirm histopathology as the gold standard for definitive diagnosis, particularly in resource-limited settings where advanced diagnostics are often inaccessible. Conclusion: ECC must remain a key differential diagnosis for any unexplained soft tissue mass in endemic areas. The reliance on and proficiency in histopathology are critical for definitive diagnosis. These findings serve as a public health sentinel, demanding integrated One Health strategies to interrupt the Taenia solium transmission cycle.
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DOI: 10.1097/rc9.0000000000000826
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