Neurocysticercosis, Meningioma, and Silent Corticotroph Pituitary Adenoma in a 61-Year-Old Woman

Maria Del Pilar Ramirez,Juan E Restrepo,Kalman Kovacs,Eva Horvath,Luis V Syro,Fabio Rotondo,Humberto Uribe,Luis C Penagos,Francisco J Londoño

doi:10.1155/2012/340840

Abstract

We report here the case of a 61-year-old woman who presented with hydrocephalus and cystic and solid lesions in sella turcica, suprasellar areas, and third ventricle. After ventriculoperitoneal shunt she developed cognitive changes and the cystic lesions enlarged. Magnetic resonance imaging (MRI) demonstrated multiple cysts and a solid lesion in the sella and around the anterior clinoid process. With diagnosis of neurocysticercosis she underwent craniotomy. Pathologic examination documented two different lesions: viable and dead cysticerci with inflaming infiltration and a left anterior clinoidal meningioma. At the second surgery, six weeks later via transnasal transsphenoidal approach a silent corticotroph pituitary adenoma was removed which was studied by histology, immunohistochemistry, and electron microscopy. To our knowledge, the occurrence of these three different lesions in the sellar area was not described before.

Highlights

Cysticercosis is the most frequent helminthic disease of the central nervous system
Neurocysticercosis refers to central nervous system infection by the parasite
After entering the central nervous system, they are in a viable stage with a transparent membrane, a clear vesicular fluid, and an invaginated scolex

Summary

Introduction

Cysticercosis is the most frequent helminthic disease of the central nervous system. It is endemic in Latin America, Asia, and Africa and it is frequently diagnosed in immigrant populations all over the world. It develops after ingestion of eggs of Taenia solium. Neurocysticercosis refers to central nervous system infection by the parasite. In the parenchymal form the cysticerci are within the brain parenchyma. The parasite loses its ability to control the host defenses and an inflammatory response leads to the death of the cysticerci. There is a wide variability in the immunological reaction of the host as well as in the multiple lesions induced by the parasites [1]

Case Report

Pathology

Discussion

Findings

Conflict of Interests