Primary Alveolar Echinococcosis Presenting with Simultaneous Cerebral and Craniofacial Involvement.

Alveolar echinococcosis (AE) is an important parasitic infestation caused by the larval stage of the Echinococcus multilocularis. Turkey is one of the countries occurred endemic of the disease. The disease primarily affects the liver. Cerebral and craniofacial involvements are very rare. Here the authors report a 46-year-old woman with simultaneous cerebral and craniofacial involvement of E. multilocularis. Although primary AE lesions with simultaneous cerebral and craniofacial involvement are exceedingly rare, radiologist must suspect from other unusual involvement such as craniofacial and muscular location in patients with cerebral AE.

Temporalis cysticerci - A diagnostic dilemma and review of literature.

Cysticercosis is a systemic parasitic infestation caused by ingesting the eggs of the pork tapeworm, Taenia solium. The central nervous system (CNS) is the most important primary site of infection and disease can present with solitary or multiple space-occupying lesion. Other organs like subcutaneous tissues, muscles, heart, liver, lungs, and peritoneum are more frequently affected but maxillofacial region involvement is rare. The diagnosis of cysticercose is evoked on US examination and CT scan, but confirmation is only possible by Fine needle aspiration cytology [FNAC] or histological examination in case of surgical removal of the oral lesion which can identify the Taenia solium larva. Solitary intramuscular cysticercosis in maxillofacial region, without involvement of CNS is a rare entity. We present a rare case of solitary temporalis muscle involvement without any systemic or neurologic infestation, which presented the diagnostic and therapeutic dilemma along with review of literature.

Human Dirofilaria repens infection of the zygomatico-temporal region.

A 40-year old patient developed a painless swelling in the left zygomatico-temporal region. Magnetic resonance images and computed tomograms showed a non-specific soft tissue mass in the tumour region, but no invasion of bone. After application of antibiotics, the tumour reduced in size but a firm mass of about 3 cm in maximum diameter persisted under therapy. Surgical exploration revealed a distinct firm mass adhering to the superficial layer of the temporal muscle. Histological and molecular biological investigations demonstrated fragments of Dirofilaria repens in the centre of the lesion. Clinical follow-up was uneventful and additional investigations excluded further manifestations of the parasite. D. repens infections are extremely rare in northern Europe, but recent reports about the increase of human dirofilariasis in northern parts of Europe should alert the clinician to include helminthoses in the differential diagnosis of atypical space-occupying lesions of the maxillofacial regions.

Cysticercosis of temporalis muscle: an unusual cause of temporal headaches. A case report.

Cysticercosis is a common parasitic infection caused by encysted larvae of the helminth Taenia solium (pork tapeworm). The central nervous system (CNS) is the most important primary site of infection and the disease can present with solitary or multiple space occupying lesions. Less common presentations in the CNS include the racemose variety with macroscopic groups of cysticerci in the subarachnoid space giving the appearance of a cluster of grapes and basal or ventricular cysticercosis causing obstructive hydrocephalus. Involvement of other organs: skeletal muscle, eyes, myocardium and the lungs has also been reported. Cases of cysticercosis presenting as isolated muscle mass (pseudotumours) without involvement of the CNS have also been recently described in the literature. We present a case of a 43-year-old woman who complained of subacute onset of left temporal pain and headache. Magnetic resonance imaging (MRI) showed characteristic imaging findings suggestive of cysticercosis of the temporalis muscle.

[Human muscle dirofilariasis of difficult diagnosis]. / Dirofilariasi muscolare umana di difficile diagnosi.

A case of Dirofilariasis by Dirofilaria repens localized in the left temporalis muscle, in a 43-year-old woman, is described. It was acquired in South-western Sicily but became apparent in Pisa. It is the seventh case of human Dirofilariasis reported from this area, confirming the existence of an endemic focus. In spite of the numerous investigations to identify clinically the illness (needle-aspirate, Echography, CTScan) the diagnosis was possible only upon discovery of the nematode in the histological sections of the surgically removed nodule.

Intramuscular onchocercoma. Case report.

Onchocerciasis is characterized by the presence of numerous microfilariae in the skin, formation of subcutaneous nodules and eye lesions that can lead to blindness. We present a case, rather uncommon in our environment, in which an incomplete life cycle of the parasite, led to a single intramuscular nodule. The clinical symptoms and histological features are described, together with the treatment, using Ivermectin.