Recurrent Neurocysticercosis: Not So Rare.

Conglomerate ring-enhancing lesions Enlarging NCC Neurocysticercosis Recurrent NCC Single ring-enhancing lesions Solitary cysticercus granuloma (SCG)

Journal

Neurology India
ISSN: 1998-4022
Titre abrégé: Neurol India
Pays: India
ID NLM: 0042005

Informations de publication

Date de publication:
Historique:
entrez: 27 4 2021
pubmed: 28 4 2021
medline: 22 6 2021
Statut: ppublish

Résumé

Solitary cysticercus granuloma (SCG) appearing as a single ring-enhancing lesion (SREL) is the most frequently encountered imaging finding in patients of neurocysticercosis (NCC) in India and during follow-up, most of SCGs resolve with or without calcifications. Recurrent SCG have been rarely reported. The aim of our study is to report the incidence of recurrent SCG in a cohort of patients with SCG and postulate the hypothesis. This retrospective study included 278 patients with SCG meeting the criteria of NCC. Their medical records and imaging studies were analyzed. Out of 278 patients, 119 patients with SCG meeting the criteria of NCC with follow-up imaging were included. 15 (12.61%) had recurrent NCC and 104 (87.4%) patients did not have any recurrence during a median follow-up of 14.23 months (range; 0.24 - 113.3) and 25.26 months (range; 3.09- 98.11) respectively. Out of 15 recurrent NCC cases, ten patients had documented imaging resolution or partial regression of previous lesion followed by occurrence of new SCG in the same location, three patients had change in morphology of lesion from solitary discrete REL to solitary conglomerate REL secondary to development of new cysticercus granuloma adjacent to old lesion patients had recurrent lesions adjacent to previous lesion and two patients had new SCG in different locations following regression of old SCGs. Recurrent SCGs are not uncommon in NCC and recurrence is more likely to occur at the site of initial infection and therefore may be mistaken for persistent infection or other granulomatous lesions.

Sections du résumé

BACKGROUND BACKGROUND
Solitary cysticercus granuloma (SCG) appearing as a single ring-enhancing lesion (SREL) is the most frequently encountered imaging finding in patients of neurocysticercosis (NCC) in India and during follow-up, most of SCGs resolve with or without calcifications. Recurrent SCG have been rarely reported.
OBJECTIVES OBJECTIVE
The aim of our study is to report the incidence of recurrent SCG in a cohort of patients with SCG and postulate the hypothesis.
MATERIALS AND METHODS METHODS
This retrospective study included 278 patients with SCG meeting the criteria of NCC. Their medical records and imaging studies were analyzed.
RESULTS RESULTS
Out of 278 patients, 119 patients with SCG meeting the criteria of NCC with follow-up imaging were included. 15 (12.61%) had recurrent NCC and 104 (87.4%) patients did not have any recurrence during a median follow-up of 14.23 months (range; 0.24 - 113.3) and 25.26 months (range; 3.09- 98.11) respectively. Out of 15 recurrent NCC cases, ten patients had documented imaging resolution or partial regression of previous lesion followed by occurrence of new SCG in the same location, three patients had change in morphology of lesion from solitary discrete REL to solitary conglomerate REL secondary to development of new cysticercus granuloma adjacent to old lesion patients had recurrent lesions adjacent to previous lesion and two patients had new SCG in different locations following regression of old SCGs.
CONCLUSION CONCLUSIONS
Recurrent SCGs are not uncommon in NCC and recurrence is more likely to occur at the site of initial infection and therefore may be mistaken for persistent infection or other granulomatous lesions.

Identifiants

pubmed: 33904459
pii: ni_2021_69_2_385_314519
doi: 10.4103/0028-3886.314519
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

385-391

Commentaires et corrections

Type : CommentIn

Déclaration de conflit d'intérêts

None

Auteurs

Khush Preet Kaur (KP)

Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.

Ajay Garg (A)

Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.

Leve Joseph Devaranjan Sebastian (LJ)

Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.

Rohit Bhatia (R)

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

Mamta Bhushan Singh (MB)

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

Achal Srivastava (A)

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

Manjari Tripathi (M)

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

M V Padma (MV)

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

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