Cisticercosis lingual. Diagnóstico, manejo clínico y tratamiento de un caso clínico / Lingual cysticercosis. Diagnosis, clinical management and treatment of a clinical case

Objetivo: Las comunicaciones bucosinusales y buco- nasales son condiciones patológicas que se caracterizan por la presencia de una solución de continuidad entre la cavidad bucal y el seno maxilar o la cavidad nasal respectivamente. Una vez que se ha instalado una comunicación es deseable ce- rrar este defecto, evitando así la infección del seno maxilar y posibles dificultades en la deglución, fonación y masticación. Se han propuesto diferentes tratamientos para su resolución, algunos no quirúrgicos y otros quirúrgicos. Los quirúrgicos pueden realizarse desplazando tejidos locales, regionales o injertando. El presente trabajo tiene como objetivo presentar situaciones clínicas de comunicaciones bucosinusales y buco- nasales con diferentes etiologías y sus distintos tratamientos según tamaño y ubicación del defecto. Casos clínicos: Se identificaron pacientes que asistie- ron al Servicio de Cirugía Maxilofacial del Hospital Piñero presentando cuatro comunicaciones bucosinusales agudas y crónicas y una comunicación buconasal crónica. Los casos analizados fueron tratados de manera quirúrgica utilizando di- versos colgajos según tamaño y ubicación del defecto (AU)

Aim: Oroantral and oronasal communications are patho- logical conditions characterized by the presence of a solu- tion of continuity between the oral cavity and the maxillary sinus or nasal cavity respectively. Once a communication has been installed, it is desirable to close this defect, thus avoid- ing infection of the maxillary sinus and possible difficulties in swallowing, phonation, and mastication. Different treatments have been proposed for its resolution, some non-surgical and others surgical. Surgical procedures can be performed by dis- placing local or regional tissue or by grafting. The aim of this case report is to present clinical situations of oral sinus and oral nasal communication with different etiologies and their different treatments according to the size and location of the defect. Clinical cases: A group of patients who attended the Maxillofacial Surgery Service of Piñero Hospital presenting four acute and chronic oral sinus and one oronasal communi- cations were identified. The analyzed cases were treated sur- gically using different flaps according to the size and location of the defect (AU)

Review of cysticercosis of maxillofacial region and report of two cases.

Cysticercosis is a parasitic infection caused by the larval stage of Taenia solium, which very rarely manifests in the maxillofacial region. It usually presents as a painless swelling. The most common site for maxillofacial cysticercosis are the tongue and lips. When humans accidently ingest the eggs of Taenia solium, they become the intermediate host, a role which is typically played by pig. This paper describes two cases of cysticercosis cellulosae, presenting as non-tender swelling of left buccal mucosa and left temporalis region respectively. Case reports available on PubMed were searched and a review was performed. Excision of cystic lesion was the treatment modality in majority of published reports. It is emphasised that cysticercosis should be considered in differential diagnosis of solitary painless swellings of oral and maxillofacial region, especially in patients from an endemic region.

Subcutaneous Taenia crassiceps Cysticercosis Mass Excision from an 11-Year-Old Mixed-Breed Dog.

An 11 yr old mixed-breed dog presented with a 2 × 3 cm semimovable subcutaneous soft-tissue mass overlying the right hip region that grew to 8 × 5 cm over a 6 mo period. Two separate fine needle aspiration cytology samples showed marked pyogranulomatous inflammation with no cytologically apparent infectious etiology or neoplasia. Computed tomography imaging revealed a well-marginated, heterogeneous, contrast-enhancing soft-tissue mass extending into the adjacent fat, suggestive of neoplasia. A 14G needle biopsy showed similar chronic inflammatory changes without evidence of neoplasia or infectious etiology. Excisional biopsy of the mass was performed, and ex vivo sectioning revealed Taenia crassiceps cysticerci. Histopathology confirmed severe chronic pyogranulomatous cellulitis and myositis with intralesional cysticerci. Anthelmintic treatment was administered postoperatively, and no evidence of local recurrence has been noted as of 6 mo after the operation. To our knowledge, this is the first case report describing the cytological, histological, cross-sectional imaging characteristics and treatment outcome of T crassiceps cysticercosis in a dog.

Muscular Cysticercosis: An Incidental Finding in the Developed World.

CASE: We present a case of muscular cysticercosis incidentally diagnosed in a patient admitted for a femoral neck fracture and submitted to total hip arthroplasty. CONCLUSION: Human cysticercosis is a parasitic infection representing a major health concern in developing countries. The clinical features are variable and depend on the anatomic location, cyst burden, cysticerci stage, and host inflammatory response. Diagnosis is commonly incidental, and prompt pattern recognition is key to diagnosis, adequate referral, and treatment. This is one of the first reports of hip arthroplasty in a patient with a history of parasitic infection (without the need for directed pathogen treatment).

Subretinal Cysticercosis in a Challenging Case: A Case Report.

Ocular cysticercosis occurs rarely and may involve various parts of the eye including subretinal space. We report a case of a 42 years-old female with diminution of vision in the right eye for one month and no vision in the left eye for 10 years. Best corrected visual acuity in the right eye was 5/60. Fundus examination showed whitish round elevated cystic mass temporal to the macula. It was confirmed as a subretinal cyst by Brightness scan and Magnetic Resonance Imaging. The subretinal cyst was removed in toto by pars plana vitrectomy followed by histopathological examination of the cyst which confirmed the diagnosis of cysticercosis. This case report highlights the importance of early diagnosis of subretinal cysticercosis which could threaten the vision in a one-eyed patient. Pars plana vitrectomy could be an effective method for subretinal cyst removal in toto even in a challenging case.

A Case Report of An Iris Epithelial Cyst Masquerading As Iris Cysticercosis.

INTRODUCTION: Iris cysts can be primary or secondary. It is common to mistake a parasitic cyst for a benign pigment epithelial cyst. However, we report a case where a benign cyst was mistaken for a parasitic cyst. CASE: A 50-year-old gentleman was seen in our OPD with gradual, progressive, painless diminution of vision in the right eye over past 5 Months. He was found to have a cystic lesion in the iris encroaching upon the pupil. OBSERVATIONS: Ultrasound biomicroscopy showed features characteristic of cysticercosis. In-toto excision of the cyst was done and was sent for histopathological examination. Histopathology failed to reveal features consistent with cysticercosis and instead showed characteristics of epithelial cyst of the iris. CONCLUSION: Histopathological examination should be done for all cystic lesions of the iris to confirm diagnosis.

Modified intraocular lens injector assisted rescue technique for failed viscoexpression in a case of intracameral cysticercosis.

Intracameral cysticercosis is a rare disease, and surgical management with viscoexpression is the preferred technique. We discuss a novel technique for removal of anterior chamber parasitic cysts and present it as an alternative to the conventional viscoexpression. Our technique uses a custom-made assembly combining an intraocular lens (IOL) cartridge with an aspiration cannula. We compare its utility with the preexisting surgical methods.

Submacular cysticercosis.

Ocular cysticercosis could involve subconjunctival space, anterior chamber, extraocular muscle, subretinal space, or vitreous. The presence of intraocular live cyst is a potential threat to visual acuity. The removal of the cyst in-toto is thus of importance to prevent inflammatory reaction and ocular damage. The presence of cysticercosis underneath the macula makes the management challenging. Herein, we describe the management of a submacular live cysticercus cyst with a good postoperative gain in visual acuity. Also, the swept-source optical coherence tomography changes are described.

Subretinal Cysticercosis Extraction With Bimanual, 3-D, Heads-Up-Assisted Pars Plana Vitrectomy: Clinicopathological Correlation and Surgical Technique.

A 16-year-old male presented with blurred vision in the right eye after recent travel to Nicaragua. Funduscopic examination revealed subretinal cysticercosis superior to the optic nerve. The cyst was drained and excised using a bimanual, three-dimensional, heads-up-assisted pars plana vitrectomy without complications. Technical maneuvers for cyst extraction along with clinicopathological correlation are described. Postoperatively, the patient exhibits no signs of recurrence and has excellent vision. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:708-711.].

Cysticercosis Masquerading as Lipo-Dermoid.

Cysticercosis is caused by the larval stage of Taenia solium (Pork tape worm). Humans are the definitive hosts where the life cycle is completed and pig is the intermediate host. Incidence in India varies from 2-38% based on the consumption of pork, general hygiene and socio-economic status of the population. The parasite on reaching the small intestine encysts itself in various tissues. Most commonly Brain, Eyes, subcutaneous tissue. Intravitreal cyst is the commonest intra ocular presentation. Death of the parasite and release of the contents of the cyst causes an intense inflammatory reaction that can be devastating. We report the condition in a nine-year-old boy who presented with mild right upper lid swelling wherein cysticercus cellulosae cyst was found within the mass of the right lateral rectus muscle. It becomes important to report this case because of the unusual site of the cyst which masqueraded as a lipo-dermoid.

Intravitreal cysticercosis with full thickness macular hole: management outcome and intraoperative optical coherence tomography features.

Ocular cysticercosis is a serious condition with a potential for complete vision loss if left untreated. Intravitreal cysticercosis is the most common ocular form of cysticercosis and is associated with retinal detachment, retinal traction, subretinal scarring and vitritis. To the best of our knowledge, there is no report of the occurrence of a live intravitreal cysticercosis with a full thickness macular hole (FTMH) in the literature. We here report a case of live intravitreal cysticercosis with a FTMH along with its management and intraoperative optical coherence tomography features of the live cysticercus.

Water lily in a subcutaneous plane - preventing complications of unplanned excision.

Human cysticercosis is caused by the larval form of Taenia solium (T. solium) and is a condition more commonly seen in tropical countries. The infestation can present with varied symptoms depending upon the site of infection, e.g. intramuscular, subcutaneous, intracerebral, or elsewhere. Diagnosing cysticercosis, although fairly easy, becomes challenging in unusual cases. Unplanned excisions can lead to catastrophic complications.

Pars Plana Vitrectomy With in Vivo Cyst Lysis for Intraocular Cysticercosis.

BACKGROUND AND OBJECTIVE: To evaluate efficacy and safety of pars plana vitrectomy (PPV) and in vivo cyst lysis for intraocular cysticercosis. PATIENTS AND METHODS: Retrospective analysis of the records of 15 patients undergoing PPV for intraocular cysticercosis at a tertiary eye care center was done. All patients had undergone in vivo cyst lysis. Of these 15 patients, one had intravitreal cysticercosis (IVC) with vitritis, two cases had IVC with vitritis with tractional retinal detachment (TRD), four cases had subretinal cysticercosis (SRC), four cases had SRC with extensive fibrosis without TRD, and five cases had SRC with fibrosis with TRD. Postoperative visual acuity at 3 months of follow-up was analyzed as the primary outcome measure. RESULTS: Mean age of patients was 26 years ± 12.27 years. Four out of 15 patients were female. Mean preoperative best-corrected visual acuity (BCVA) was 1.55 logMAR units ± 0.62 logMAR units, whereas mean postoperative BCVA at last follow-up (3 months) was 1.26 logMAR units ± 0.65 log-MAR units. Mean visual gain (0.29 logMAR units) post-surgery was statistically significant (P = .018). The final visual acuity correlated with preoperative BCVA with Pearson's coefficient being 0.78 (95% CI, 0.44-0.92; P = .001). Anatomical success was achieved in 13 of 15 (87%) cases. In one case the cyst was dead and calcified and could not be removed. TRD was associated with poor visual gain. CONCLUSION: Intravitreal cyst lysis is a safe and successful approach for managing intraocular cysticercosis. Visual results depend on preoperative condition. TRD implicates poor visual prognoses. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:665-669.].

A new surgical "noose" technique for excision of pediatric ocular adnexal and anterior orbital cysts.

We describe a "noose technique" that facilitates complete surgical excision of all forms of pediatric adnexal and anterior orbital extraocular cysts, including conjunctival retention cysts, parasitic cysts involving the conjunctiva, Tenon's capsule, or rectus muscle, superficial cysts, and deep dermoid cysts. The technique provides good exposure and facilitates handling of tissues, maintains surgical planes, minimizes bleeding, decreases injury to collateral tissues, reduces surgical time, allows for utilization of less skilled assistants, and ensures complete excision in most cases. The noose technique is a versatile procedure that can be applied to extraocular cysts of any location or size both in children and adults. We demonstrate the technique in 3 different pediatric extraocular cysts.