MRI and ultrasound in solitary muscular and soft tissue cysticercosis

Abstract

Solitary cysticercosis of muscles and soft tissue is a rare disease and can cause a diagnostic dilemma clinically. We present the MRI and ultrasound findings in six patients with solitary muscular and soft tissue cysticercosis. Five of them had clear cysts that displayed low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Four of these cysts had scolices within them. One patient had an ill-defined hyperintense lesion on T2-weighted images without any clear cyst. Ultrasound performed in all patients showed similar findings, with the scolices being more clearly appreciated. MRI and ultrasound are useful in the diagnosis of solitary muscular and soft tissue cysticercosis and they reliably establish the diagnosis when a clear cyst with scolex is seen.

Cysticercosis of Soleus muscle presenting as isolated calf pain

“…MRI is the diagnostic modality of choice for soft tissue cysticercosis imaging. 3 Our patient too had acute presentation and was …”

“…Screening Brain MRI with extended focus on bilateral orbits did not show any evidence of Neurocysticercosis or Ocular Cysticercosis. Blood investigations showed Hb of 8 g% with total leukocyte count of 12,000 cells/mm 3 and differential count revealed eosinophilia of 40%. ELISA for IgG antibodies against T. solium was positive, which confirmed the diagnosis.…”

Isolated Muscular Cysticercosis: A Rare Pseudotumor and Diagnostic Challenge, can It be treated Nonoperatively? A Report of Two Cases and Review of Literature

“…The other common pseudotumors causing similar presentation includes lipomas, neurofibromas, epidermoid cysts, pyomyositis or tuberculous lymphadenitis. 10,19,21 In case one, lipoma or neurofibroma were our principle clinical differential diagnosis. In the absence of constitutional symptoms possibility of pyomyositis and tuberculous lymphadenitis was very unlikely.…”

“…Muscular cysticercie can be reliably diagnosed on ultrasound. 2,10,23,28,29 MRI assess the degree of infection and exact plane of lodgement of cyst in soft tissues. It visualises well the perilesional edema and the degenerative changes of the parasite.…”

“…3 Isolated muscular involvement is a rare finding 4 and because of the nonspecific symptoms, isolated soft tissue cysticercosis is very difficult to diagnose. 5 Till date there are only handfull cases [6][7][8][9][10][11][12][13] of isolated muscular cysticercosis are reported. We are reporting here two cases of isolated myocysticercosis which produced diagnostic dilemma on clinical presentation, accurately diagnosed by ultrasound and MRI examination and successfully treated noninvasively with oral antihelmenthic medication and steroid combination.…”