Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Neurocysticercosis Involving the Pituitary Stalk : Case Report and Literature Review

  • Cheong, Jin-Hwan (Department of Neurosurgery, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Kim, Jae-Min (Department of Neurosurgery, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Kim, Choong-Hyun (Department of Neurosurgery, Hanyang University Guri Hospital, Hanyang University College of Medicine)
  • Received : 2009.11.20
  • Accepted : 2010.06.14
  • Published : 2010.07.28
Download PDF
⟨ Previous Next ⟩

Abstract

Neurocysticercosis (NCC) is the most common parasitic infestation of the central nervous system. Most cases of NCC are to related and/or associated with inflammation within the cerebral parenchyma. A 71-year-old woman presented with a 4-year history of visual disturbance. This symptom had become aggravated 4 weeks earlier. Her visual acuity gradually decreased and superior hemianopsia was noted. Magnetic resonance imaging (MRI) revealed an enhanced and thickened pituitary stalk accompanying a suspicious mass. The provisional diagnoses were lymphoma, glioma, or other inflammatory conditions. Laboratory studies, including blood and hormonal studies, showed normal findings. Surgical resection was performed. In the pathological examination, degenerated parasitic wall structure was seen and its contents were composed of completely degenerated focal globular structures suggesting the scolex of cysticercus. We report an unusual case of NCC involving the pituitary stalk which was presented with a juxtasellar tumor. The possible underlying mechanisms are discussed with a review of pertinent literature.

Keywords

References

  1. Arriada-Mendicoa N, Celis-Lopez MA, Higuera-Calleja J, Corona-Vazquez T : Imaging features of sellar cysticercosis. AJNR Am J Neuroradiol 24 : 1386-1389, 2003
  2. Carpio A. Neurocysticercosis : an update. Lancet Infect Dis 2 : 751-762, 2002 https://doi.org/10.1016/S1473-3099(02)00454-1
  3. Couldwell WT, Zee CS, Apuzzo ML : Definition of the role of contemporary surgical management in cisternal and parenchymatous cysticercosis cerebri. Neurosurgery 28 : 231-237, 1991 https://doi.org/10.1227/00006123-199102000-00009
  4. Del Brutto OH, Rajshekhar V, White AC Jr, Tsang VC, Nash TE, Takayanagui OM, et al. : Proposed diagnostic criteria for neurocysticercosis. Neurology 57 : 177-183, 2001 https://doi.org/10.1212/WNL.57.2.177
  5. Del Brutto OH, Sotelo J : Neurocysticercosis: an update. Rev Infect Dis 10 : 1075-1087, 1988 https://doi.org/10.1093/clinids/10.6.1075
  6. Dua T, Aneja S : Neurocysticercosis: management issues. Indian Pediatr 43 : 227-235, 2006
  7. Garcia HH, Gonzalez AE, Evans CA, Gilman RH; Cysticercosis Working Group in Peru : Taenia solium cysticercosis. Lancet 362 : 547-556, 2003 https://doi.org/10.1016/S0140-6736(03)14117-7
  8. Garcia HH, Pretell EJ, Gilman RH, Martinez SM, Moulton LH, Del Brutto OH, et al. : A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis. N Engl J Med 350 : 249-258, 2004 https://doi.org/10.1056/NEJMoa031294
  9. Hutcheson K 3rd, Kalafian M, Taylor I, Sagel J, Clyburn B : Neurocysticercosis. South Med J 93 : 666-668, 2000
  10. Kim SK, Wang KC, Paek SH, Hong KS, Cho BK : Outcomes of medical treatment of the neurocystiercosis : a study of 65 cases in Cheju Island, Korea. Surg Neurol 52 : 563-569, 1999 https://doi.org/10.1016/S0090-3019(99)00158-5
  11. Murthy JM, Yangala R : Etiological spectrum of localization-related epilepsies in childhood and the need for CT scan in children with partial seizures with no obvious causation--a study from south India. J Trop Pediatr 46 : 202-206, 2000 https://doi.org/10.1093/tropej/46.4.202
  12. Rajshekhar V, Haran RP, Prakash GS, Chandy MJ : Differentiating solitary small cysticercus granulomas and tuberculomas in patients with epilepsy. Clinical and computerized tomographic criteria. J Neurosurg 78 : 402-407, 1993 https://doi.org/10.3171/jns.1993.78.3.0402
  13. Sciutto E, Fragoso G, Fleury A, Laclette JP, Sotelo J, Aluja A, et al. : Taenia solium disease in humans and pigs : an ancient parasitosis disease rooted in developing countries and emerging as a major health problem of global dimensions. Microbes Infect 2 : 1875-1890, 2000 https://doi.org/10.1016/S1286-4579(00)01336-8
  14. Sinha S, Sharma BS : Neurocysticercosis : a review of current status and management. J Clin Neurosci 16 : 867-876, 2009 https://doi.org/10.1016/j.jocn.2008.10.030
  15. Yoon JW, Rhee DY, Park H, Park HS, Kim SY : A case of neurocysticercosis presenting with myelopathy and hydrocephalus. J Korean Neurosurg Soc 31 : 82-85, 2002

Cited by

  1. Intrasellar cysticercosis: a systematic review vol.113, pp.3, 2010, https://doi.org/10.1007/s13760-013-0199-1
  2. Single center study of 53 consecutive patients with pituitary stalk lesions vol.21, pp.6, 2010, https://doi.org/10.1007/s11102-018-0914-2
  3. Intrasellar cysticercosis cyst treated with a transciliary supraorbital keyhole approach – A case report vol.11, pp.None, 2010, https://doi.org/10.25259/sni_755_2020
  4. Current approaches to cysticidal drug therapy for neurocysticercosis vol.18, pp.8, 2020, https://doi.org/10.1080/14787210.2020.1761332