Isolated Intramuscular Cysticercosis—a Case Series

Isolated muscular cysticercosis is an emerging problem worldwide with varied presentation. The initial presentation mimics a soft tissue mass, but imaging arouses suspicion. This article is an endeavour to understand the diagnostic challenges, management protocols and recent trends in the disease process. A case series analysis was conducted in a tertiary care hospital between Jan 2019 and Mar 2020. Clinical data and management protocols were retrieved from hospital records and patient follow-up notes. Statistical analysis done used SPSS version 23. Nine cases (36%) out of 25 had solitary muscular involvement with seven men (77.7%) and two women (22.23%). The average age was 39.2 SD 10.5 years. The most common site of infection was thigh (33.33%) and calf (22.23%). The difference in mean volume of the lesions in medically and surgically treated patients was statistically significant (p = 0.04). There was a strong positive correlation between age of the individual and the volume of the lesion (correlation coefficient r = 0. 87). All cases had grossly elevated IgG levels (range 12.87–25.5 IU/dL). Five patients underwent surgery and rest were managed medically. The mean IgG levels in medical (18.12 SD 3.86) and surgical (18.61 SD 4.83) groups were insignificant (p = 0.87). Isolated muscular cysticercosis should always be kept in mind as a differential diagnosis in all patients from an endemic area, presenting with an isolated muscular lesion. Surgical excision is required in non-responsive cases or large lesions causing significant pressure effects or cosmetic problems and rest can be managed conservatively.