Cheek cysticercosis - To Treat or Not to Treat
Dhruv Gandhi1, Shatakshi Garg1, Zahabiya Nalwalla1, Balagopal Kurup2, Tejas Athalye2, Sunita Sharma3, Ira Shah1
1Department of Pediatric Infectious Diseases, B J Wadia Hospital for Children, Mumbai, India, 2Department of ENT, B J Wadia Hospital for Children, Mumbai, India, 3Department of Pathology, B J Wadia Hospital for Children, Mumbai, India
Address for Correspondence: Dhruv Gandhi, 5B/13 Shyam Niwas, Breach Candy, Mumbai-400026, India.
Email: dhruvgandhi2610@gmail.com
Keywords: Cheek cysticercosis, oral cysticercosis, cysticercosis cellulosae, Taenia solium, pig tapeworm, cheek swelling
Clinical Problem :
A 14-year-old boy presented with a painless, progressively enlarging right cheek swelling for six months. There was no fever or trauma. He had a mixed dietary pattern. On examination, there was a solitary, non-tender, freely mobile, well-defined, smooth, firm swelling in the right cheek measuring approximately 1.5 X 1.0 cm. Oral cavity examination was normal. Other systemic and general examination were normal. Ultrasonography (USG) of the cheek showed an intramuscular well defined cystic lesion measuring 1.4 X 1.2 mm with a central echogenic focus measuring 0.3 X 0.2 mm and thin septae suspicious of a dermoid cyst or epidermal inclusion cyst. Surgical excision of the cyst was performed. On microscopic examination, an undulating cyst wall resting on skeletal muscle and adipose tissue and lined by foamy histiocytes was seen. The separate soft tissue mass on sectioning revealed irregularly shaped membranous infoldings representing cysticercus larvae. Histopathology was suggestive of cysticercus cellulosae of the cheek (Figure 1). Subsequently, a magnetic resonance imaging (MRI) brain was done to rule out neurocysticercosis which was normal and ophthalmology examination was also normal.
Figure 1. Histopathology showing an ulcerated cyst wall suggestive of cysticercus cellulose.
|
Should the child be treated with antihelminthics?
|
|
|
|
|