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      Intramedullary Spinal Neuorocysticercosis

      letter
      Korean Journal of Spine
      The Korean Spinal Neurosurgery Society

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          Abstract

          Dear Editor, the report on "spinal neuorocysticercosis" is very interesting1). Kim et al. reported a case and concluded that "Even though the prevalence of intramedullary spinal cysticercosis is extremely rare, and radiologic exams mimic other common tumors like ependymoma or astrocytoma, the disease should be considered as differential diagnosis1)." In fact, the problem of spinal cysticercosis can be sporadically seen and can be seen at any age group2). As a tissue parasitic infestation, the final diagnosis is usually due to histological examination of surgical specimen. Using MRI, it might be useful for detection of mass lesion, however, it is impossible to differentiate it. Recently Yoo et al. noted that "MR imaging is a sensitive diagnostic tool for detecting cystic lesions in the spine; however, it is difficult to distinguish cysticercosis from non-infectious cysts such as an arachnoid cyst without using gadolinium enhancement3)." Del Brutto and Garcia noted that "the visualization of the scolex or the incidental discovery of intracranial lesions provide helpful diagnostic clues4)".

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          Most cited references4

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          A Case of Intradural-Extramedullary Form of Primary Spinal Cysticercosis Misdiagnosed as an Arachnoid Cyst

          We describe a rare case of intradural-extramedullary primary spinal cysticercosis. A 42-year-old man visited our institute for lower back pain. He denied having consumed raw meet. Magnetic resonance (MR) images revealed an intradural pure cystic mass at the L3-L4 level. A radiologic diagnosis of spinal arachnoid cyst was established. Three years later, he complained of aggravated back pain, and follow-up MR examination showed a markedly expanded cyst, occupying the subarachnoid space from the T11 to the S1 level. L2 hemilaminectomy was performed, and a yellowish infected cyst bulged out through the dural opening. The cyst was removed en bloc. The histopathological findings of the cyst were consistent with parasitic infection. Serum enzyme-linked immunosorbent assay (ELISA) confirmed the presence of spinal cysticercosis. As there was no intracranial lesion, the final diagnosis was primary spinal cysticercosis, which is very rare. MR imaging is a sensitive diagnostic tool for detecting cystic lesions in the spine; however, it is difficult to distinguish cysticercosis from non-infectious cysts such as an arachnoid cyst without using gadolinium enhancement. Clinicians treating spinal cysts with an unusual clinical course should include cysticercosis as a differential diagnosis. We recommend contrast-enhanced MR imaging and serum ELISA in the diagnostic work-up of such cases.
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            Intramedullary cysticercosis of the spinal cord: a review of patients evaluated with MRI.

            Review of cases of intramedullary spinal cord cysticercosis diagnosed with MRI to outline the features and outcome of this overlooked form of presentation of neurocysticercosis.
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              Intramedullary Spinal Cysticercosis: A Case Report and Review of Literature

              To report a case of spinal intramedullary cysticercosis in thoracic spine. A 47-year old man living in Korea referred to our hospital with both feet tingling sensation for about a year. Laboratory evaluations, including serologic tests were not helpful. Magnetic resonance imaging revealed a 1.7 cm intramedullary mass at T10-11 level, which believed to be a tumor instead, rather than a cysticercosis preoperatively. Successful operation was done with a histopathological result confirmed it as cysticercosis. Even though the prevalence of intramedullary spinal cysticercosis is extremely rare, and radiologic exams mimic other common tumors like ependymoma or astrocytoma, the disease should be considered as differential diagnosis.
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                Author and article information

                Journal
                Korean J Spine
                Korean J Spine
                KJS
                Korean Journal of Spine
                The Korean Spinal Neurosurgery Society
                1738-2262
                2093-6729
                December 2014
                31 December 2014
                : 11
                : 4
                : 258
                Affiliations
                Wiwanitkit House, Bangkhae, Bangkok, Thailand.
                Author notes
                Corresponding Author: Viroj Wiwanitkit, MD. Hainan Medical University, Wiwanitkit House, Bangkhae, Bangkok, Thailand. Tel: +866624132436, Fax: +866624132436, wviroj@ 123456yahoo.com
                Article
                10.14245/kjs.2014.11.4.258
                4303281
                baff48a8-ee22-46fc-8303-d3bfa5c9a864
                Copyright © 2014 The Korean Spinal Neurosurgery Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 August 2014
                : 30 November 2014
                : 02 December 2014
                Categories
                Letter to Editor

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