Disseminated cutaneous cysticercosis with oral involvement: A rare presentation of cysticercosis

A 25-year-old man presented with multiple asymptomatic swellings over the neck and abdomen for 3 months. There was a history of headache and seizure episodes. Examination revealed multiple discrete 1×1 cm cystic swellings over the neck, floor of the mouth, and over the abdomen [Figures 1a and b]. Ultrasonography revealed multiple anechoic subcentimetric oval lesions with round echogenic nodules within the neck muscles [Figure 2a]. Magnetic resonance imaging confirmed the presence of granular, nodular, and calcified stages of neurocysticercosis within the brain parenchyma, muscles of the neck, eye muscles, tongue, floor of mouth, lower limb, and pericardium [Figure 2b and 2c]. The patient was diagnosed with disseminated cutaneous and oral cysticercosis and referred to a higher center for management.

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Figure 1: (a) Multiple discrete cystic swellings present on the right side of the neck. (b) Multiple cystic bluish swellings present over the floor of the mouth and the undersurface of the tongue.

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Figure 2: (a) Ultrasonography of the swellings showing multiple anechoic subcentimetric oval lesions with eccentric round echogenic nodules within the neck muscles (blue arrow). (b) Magnetic resonance imaging T2 weighted image (MRI T2WI) sagittal section showing diffuse granular nodular cysticerci in the brain parenchyma, pharyngeal wall, lips, tongue (orange arrow), and neck muscles. (c) Magnetic resonance imaging T1 weighted image (MRI T1WI) axial section of brain (including bilateral orbits) showing cysticerci diffusely in bilateral extraocular muscles (blue arrows), bilateral visualised temporal lobes and occipital lobes, cerebellum, and temporalis muscles.

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