ArticleSurgical neurology international2026
Solitary neurocysticercosis mimicking tuberculoma and glioblastoma: A diagnostic challenge in a low-resource setting.
Article in Surgical neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Neurocysticercosis (NCC) is the most common parasitic infection of the central nervous system and a major cause of acquired epilepsy in endemic regions. Solitary parenchymal lesions frequently mimic tuberculoma or high-grade glioma, posing a significant diagnostic challenge, particularly in tuberculosis-endemic and resource-limited settings. Case Description: We report the case of a 60-year-old male farmer with diabetes mellitus who presented with a 1-week history of focal seizures with secondary generalization and progressive left-sided weakness. Neurological examination revealed a Glasgow Coma Scale score of 15/15 and grade 4+ power in the left upper and lower limbs, with no sensory deficit. The patient had a prior history of treated pulmonary tuberculosis. Brain magnetic resonance imaging demonstrated a solitary ring-enhancing lesion in the right medial frontal lobe, with differential diagnoses of tuberculoma versus high-grade glioma. He underwent right parietal craniotomy with a transcortical approach and gross total excision of a well-circumscribed lesion. Histopathological examination revealed a cysticercus larva with surrounding inflammatory infiltrate, confirming NCC. Postoperatively, the patient received albendazole (15 mg/kg/day) for 2 weeks and continued antiepileptic therapy. Follow-up imaging showed complete resolution of the lesion, and the patient remained seizure-free with full neurological recovery. Conclusion: NCC should be considered in the differential diagnosis of solitary ring-enhancing brain lesions even in patients with prior tuberculosis. When imaging is inconclusive, surgical excision provides definitive diagnosis and effective treatment with excellent neurological and seizure outcomes.
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