A 60-year-old retired construction worker in Spain, initially believed to have advanced metastatic brain cancer, was instead diagnosed with a rare parasitic infection caused by tapeworm larvae in his central nervous system, according to a case report in Emerging Infectious Diseases.
The patient sought medical help after experiencing a worsening headache for two weeks and subtle behavioral changes.
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A CT scan revealed multiple fluid-filled lesions and severe swelling in his brain, leading doctors to suspect cancer.
Because the man was not immunocompromised and had not traveled internationally, metastatic cancer seemed likely.
However, a whole-body scan, colonoscopy, and PET scan found no primary tumors or malignancies.
A high-resolution MRI then showed that the brain lesions were not tumors but encapsulated pork tapeworm larvae with visible worm heads.
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The infection was traced to his construction career, where he shared bathrooms and meals with coworkers from regions where the parasite is endemic.
Blood tests confirmed antibodies against the parasite, leading to a diagnosis of neurocysticercosis.
The researchers noted that the absence of travel history should not rule out the condition when multiple ring-enhancing brain lesions are present.
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The patient fully recovered after treatment with anti-inflammatory corticosteroids and two specialized antiparasitic medications.
