A woman was admitted to Georgian surgeons with a diagnosis of a malignant brain tumor complicated by generalized convulsive syndrome. However, during the operation, instead of a tumor, doctors discovered a live adult parasitic flatworm. Neurosurgeon Georgiy Sekaniya wrote about this 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 which case the brain damage is called cysticercosis), or by accidentally swallowing the eggs of parasitic worms from cats, dogs, or other carnivorous mammals, as in echinococcosis or sparganosis. The larvae become encapsulated in brain tissue and can cause neurological symptoms of varying severity, but their ability to develop into adults has not been known.
Neurosurgeon Giorgi Sekania from the Caucasus Medical Center and Innova Medical Center in Tbilisi reported what is likely the first case in the history of medicine where an adult parasitic flatworm was found in the human brain. Shortly before being admitted to a Georgian clinic, the patient had undergone a sectoral resection of the mammary gland abroad due to cancer, and during a general oncology examination, a formation in the right temporal lobe was detected on an MRI, which became the reason for the diagnosis. According to her, she had undergone eight MRIs of the head in three years. She refused the operation and returned to her homeland. Local surgeons consulted the patient, assumed the metastatic nature of the tumor and suggested its removal. During the preoperative examination, the MRI showed that the formation had moved from the temporal lobe to the parietal lobe.
Due to the intracerebral (three centimeters from the outer surface) location of the formation, an ultrasound was performed immediately before its removal during the operation. It showed that the damage was clearly differentiated from the surrounding tissue, surrounded by edema and abnormally vascularized, which is not typical for malignant tumors. During the removal, a live, mobile 15-centimeter parasitic worm was found near the posterior horn of the right lateral ventricle of the brain, which was completely removed without violating its integrity. The extracted helminth was sent for analysis to the Institute of Parasitology, where it was identified as an adult pork tapeworm (Taenia solium).
An adult flatworm has apparently been found in the human brain for the first time (the surgeons who performed the operation and the PubMed database did not have any similar data). Doctors are continuing to study this case and are preparing to publish it in a peer-reviewed scientific journal. The patient feels well after the operation and has no neurological symptoms.
Previous cases have been described of a man whose pork tapeworm larvae in the brain caused epileptic seizures 20 years after infection, and of 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.