A woman was admitted to Georgian surgeons with a diagnosis of a malignant brain tumor complicated by generalized seizure disorder. However, during surgery, instead of a tumor, doctors discovered a live adult parasitic flatworm. Neurosurgeon Giorgi Sekania shared the case on Facebook*.
Flatworm larvae can enter the human brain either through the bloodstream from an adult worm in the intestine, as in taeniasis (in this case, the brain damage is called cysticercosis), or through accidental ingestion of parasitic worm eggs from cats, dogs, or other carnivorous mammals, as in echinococcosis or sparganosis. The larvae encapsulate in brain tissue and can cause neurological symptoms of varying severity, but the possibility of their development into adults has not been known until now.
Neurosurgeon Giorgi Sekania of the Caucasus Medical Center and Innova Medical Center in Tbilisi reported what is believed to be the first case in medical history of an adult parasitic flatworm being detected in the human brain. Shortly before being admitted to a Georgian clinic, the patient underwent a breast resection abroad for cancer. During a general oncology workup, an MRI revealed a mass in her right temporal lobe, which led to the diagnosis. According to her, she had undergone eight head MRIs over three years. She declined surgery and returned to her home country. Local surgeons consulted the patient, suspected a metastatic tumor, and recommended its removal. A preoperative MRI revealed that the mass had migrated from the temporal lobe to the parietal lobe.
Due to the intracerebral location of the tumor (three centimeters from the outer surface), an ultrasound was performed immediately prior to its removal during surgery. It revealed that the lesion was clearly differentiated from the surrounding tissue, surrounded by edema, and abnormally vascularized, which is unusual for malignant tumors. During the removal, a live, motile, 15-centimeter-long parasitic worm was discovered near the posterior horn of the right lateral ventricle of the brain. It was completely removed without disturbing its integrity. The extracted worm was sent for analysis to the Institute of Parasitology, where it was identified as an adult pork tapeworm (Taenia solium).
This is apparently the first time an adult flatworm has been detected in the human brain (the surgeons who performed the operation and the PubMed database found no similar data). Doctors are continuing to study this case and are preparing to publish it in a peer-reviewed scientific journal. The patient is feeling well after the surgery and has no neurological symptoms.
Previously, there were cases of a man whose pork tapeworm larvae in the brain caused epileptic seizures 20 years after infection, and a woman whose brain contained a larva of the parasitic worm Ophidascaris robertsi, which lives in the gastrointestinal tract of reticulated pythons.
Facebook* is owned by Meta, a company banned in Russia.
