Teaching NeuroImages: Spinal intramedullary cysticercosis: The pseudotumoral form

A 10-year-old boy was admitted to the hospital with decreased muscle strength in lower limbs. Physical examination revealed isolated spastic crural paraparesis. MRI of the thoracic spine demonstrated a cystic intramedullary lesion (figure 1). The patient underwent complete microsurgical resection of the lesion. Anatomopathologic report (figure 2) confirmed cysticercosis. Intramedullary cysticercosis is a rare parasitic infection caused by Taenia solium (0.7%–5.8% of all patients with neurocysticercosis).1 This presentation is usually underdiagnosed because, in degeneration phases, it is difficult to visualize the parasite in the MRI, mainly the scolex, and immunologic tests are negative due to intraparenchymal location.2