Giant intracranial neurocysticercosis mimicking brain tumors: Two illustrative cases with a practical neurosurgical decision-making algorithm.
- 1Department of Neurosurgery, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Mexican Institute of Social Security (IMSS), Mexico City, Mexico.
- 2Department of Neuropathology, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Mexican Institute of Social Security (IMSS), Mexico City, Mexico.
Abstract
Background
Giant parenchymal neurocysticercosis (NCC) is a rare Taenia solium infection that can mimic neoplasms or cystic lesions. Its appearance, mass effect, and risk of neurological deterioration may complicate diagnosis and management, especially when surgery is considered.Case description
We present two cases of giant parenchymal NCC initially diagnosed as intracranial neoplasms because of radiological findings and mass effect. Both patients underwent surgery for neurological deterioration and diagnostic uncertainty. In the first case, intraoperative findings suggested NCC, later supported by response to antiparasitic therapy. In the second, frozen section and histopathology confirmed NCC, allowing modification of the oncological procedure and avoidance of extensive resection. Both patients received antiparasitic treatment and had favorable clinical outcomes. Literature review showed that surgery in giant intracranial NCC has been driven by mass effect, neurological deterioration, or diagnostic uncertainty.Conclusion
Giant parenchymal NCC should be included in the differential diagnosis of large cystic intracranial lesions, especially in patients exposed to endemic regions. When findings are inconclusive and deterioration or mass effect is present, surgery may confirm diagnosis and guide further treatment. Intraoperative pathology can avoid unnecessary resection.
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BibTeX
@article{toache2026giant,
title = {{Giant intracranial neurocysticercosis mimicking brain tumors: Two illustrative cases with a practical neurosurgical decision-making algorithm.}},
author = {Kevin S Toache and Flavio Hernández González and Víctor Correa-Correa and Edgar F Higuera-Gonzalez and Marco A Rodriguez-Florido and Julio C López-Valdés and Blas E López-Félix and Bayron A Sandoval-Bonilla},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_1085_2026},
url = {https://europepmc.org/article/MED/42974577},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Giant intracranial neurocysticercosis mimicking brain tumors: Two illustrative cases with a practical neurosurgical decision-making algorithm.
AU - Kevin S Toache
AU - Flavio Hernández González
AU - Víctor Correa-Correa
AU - Edgar F Higuera-Gonzalez
AU - Marco A Rodriguez-Florido
AU - Julio C López-Valdés
AU - Blas E López-Félix
AU - Bayron A Sandoval-Bonilla
PY - 2026
DA - 2026/10/30
JO - Surgical neurology international
DO - 10.25259/sni_1085_2026
UR - https://europepmc.org/article/MED/42974577
AB - Background Giant parenchymal neurocysticercosis (NCC) is a rare Taenia solium infection that can mimic neoplasms or cystic lesions. Its appearance, mass effect, and risk of neurological deterioration may complicate diagnosis and management, especially when surgery is considered.Case description We present two cases of giant parenchymal NCC initially diagnosed as intracranial neoplasms because of radiological findings and mass effect. Both patients underwent surgery for neurological deterioration and diagnostic uncertainty. In the first case, intraoperative findings suggested NCC, later supported by response to antiparasitic therapy. In the second, frozen section and histopathology confirmed NCC, allowing modification of the oncological procedure and avoidance of extensive resection. Both patients received antiparasitic treatment and had favorable clinical outcomes. Literature review showed that surgery in giant intracranial NCC has been driven by mass effect, neurological deterioration, or diagnostic uncertainty.Conclusion Giant parenchymal NCC should be included in the differential diagnosis of large cystic intracranial lesions, especially in patients exposed to endemic regions. When findings are inconclusive and deterioration or mass effect is present, surgery may confirm diagnosis and guide further treatment. Intraoperative pathology can avoid unnecessary resection.
SN - 2229-5097
SN - 2152-7806
ER -