Solitary Cysticercosis of Temporalis Muscle: A Rare and Challenging Diagnosis

Abstract

Taeniasis is an endemic parasitic infection of developing countries, including India. It is caused by pork (Taenia solium), beef (Taenia saginata), and Asian (Taenia asiatica) tapeworms and the route of transmission is faeco-oral. It usually occurs due to ingestion of uncooked green leafy vegetables, undercooked meat or unsafe drinking water contaminated with faeces. The mode of presentation can be severe in the form of Neurocysticercosis (brain) or Solitary Muscular Cysticercosis. Neurocysticercosis can prove to be fatal and life-threatening condition in the form of seizures and focal neurological signs. Diagnosis of cysticercosis is usually based on direct stool examination for eggs on three consecutive days or proglottids of the tapeworm, serological tests such as Enzyme Linked Immunosorbent Assay (ELISA) and radiological imaging for confirmation. Here, a rare and very interesting case of cysticercosis was reported in temporalis muscle in a young female. The patient presented with only a solitary swelling in preauricular region. Both radiological and microbiological investigations played a very vital role in the diagnosis and the patient was finally diagnosed as a case of muscular cysticercosis. She was started on conservative treatment with albendazole and steroids for two weeks. Repeat radiological scans showed improvement in her swelling and complete resolution in about a month. Cysticercosis of temporalis muscle is in itself a very rare event and there are only a few reported cases in literature. The present case was also unique in terms of localisation of the cyst as it was inside the superficial fibers and fascia of the muscle and not intramuscularly.