title: Isolated pancreatic cysticercal cyst presenting as a diagnostic challenge: diagnosis and treatment review.
abstract: Human cysticercosis most commonly affects the subcutaneous tissues, skeletal muscles, lungs, brain, eyes, liver and, rarely, the heart, thyroid and pancreas. Owing to vague clinical presentation and unfamiliarity of clinicians with this entity, it is difficult to diagnosis when seen as an isolated cyst. We present a case of a 16-year-old boy who presented with an upper abdominal lump and jaundice. Ultrasonography (USG) and MRI of the abdomen were carried out, which revealed a cystic mass (8.5 × 7 × 7 cm) in the pancreas. No evidence of solid component or papillary projections was noted within the lesion. Tumour markers carcinoembryonic antigen (CEA) and cancer antigen (CA 19-9) were normal. Fine needle aspiration cytology was performed, which revealed the presence of cysticercus larvae, along with a foreign body giant cell reaction. The patient was treated with therapeutic aspiration and antihelminthic therapy. Since then, he has been symptom free and under regular follow-up for the last 1 year. A diagnosis of cysticercal cyst at atypical sites is very rare and depends mainly on histopathological examination, which, along with USG and MRI, can give an accurate analysis. These cysts can be very well treated non-surgically with antihelminthics and aspiration.
authors.affiliation: Department of General Surgery, Maulana Azad Medical College, New Delhi, India.
authors.forename: Raman
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of General Surgery, Maulana Azad Medical College, New Delhi, India.
authors.forename: Sushanto
authors.initials: S
authors.lastname: Neogi
mesh_terms: D000293:Adolescent; D000818:Animals; D014408:Biomarkers, Tumor; D044963:Biopsy, Fine-Needle; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D003552:Cysticercus; D003937:Diagnosis, Differential; D015726:Giant Cells; D006801:Humans; D007814:Larva; D008279:Magnetic Resonance Imaging; D008297:Male; D010179:Pancreas / Q000469:parasitology* / Q000473:pathology; D010181:Pancreatic Cyst / Q000175:diagnosis* / Q000469:parasitology / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000469:parasitology / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen