Disseminated cysticercosis with tongue involvement: a rare case report from Nepal

Introduction and importance: Cysticercosis is a condition in which humans are infected by the larval form of the pork tapeworm Tenia solium. Cysticercosis in humans is common in the cerebral tissue but rare in the tongue. Case presentation: Here, the authors report a rare case of a 38-year-old male with neurocysticercosis and cysticercosis of the tongue. The patient presented with a complaint of loss of consciousness for 4-5 min. Local examination of his oral cavity revealed a swelling of similar to 2 x 2 cm on the tongue. An MRI of the brain showed various stages of neurocysticercosis involving the neuroparenchyma and tongue. For this, he was started on low-dose prednisolone of 50 mg tapered over 6 weeks and levetiracetam of 500 mg BD continued for his seizure episodes. He is responding well with the medications and is planned to start antiparasitic agent only after the perilesional edema decreases. Clinical discussion: Cysticercosis may involve the central nervous system, muscle, heart, lungs, peritoneum, eye, and subcutaneous tissue. Oral cavity and perioral involvement by cysticercous larva is rare in humans. Radiologic imaging, serology, and tissue biopsy can be used to confirm a diagnosis of cysticercosis. The most common locations for oral cysticercosis are the tongue, buccal mucosa, lower lip, and upper lip. Only 102 cases of oral cysticercosis have been reported based on a PubMed English-language literature search. Conclusion: Oral cysticercosis is a rare event, and it represents a difficulty in clinical diagnosis. But a patient with a mass in the tongue should be considered as a possible case of cysticercosis especially in endemic regions like Nepal.