Case Report: Multiple Schistosomiasis Japonica Cerebral Granulomas without Gastrointestinal System Involvement: Report of Two Cases and Review of Literature

Am J Trop Med Hyg. 2020 Jun;102(6):1376-1381. doi: 10.4269/ajtmh.19-0797.

Abstract

Most schistosomiasis japonica cerebral granulomas reported in the literature have been single and located in the cerebellum, and multiple lesions located in the cerebral hemisphere are uncommon and often misdiagnosed as metastases or gliomas. We describe two rare cases of multiple schistosomiasis japonica cerebral granulomas. Laboratory examinations and cerebrospinal fluid were normal. Parasite eggs were not detected in the stool. No positive findings were detected in the abdominal ultrasonography or chest radiography. Magnetic resonance revealed two intensive patchy lesions in the cerebral hemisphere and surrounded by a large area of edema in both of our patients. Both were misdiagnosed as glioma or metastatic carcinoma before operation. Pathological examination confirmed that the diagnosis was schistosomiasis japonica cerebral granuloma. Praziquantel and dexamethasone were administered. Both patients are alive, symptom-free, and without evidence of recurrence. Combining our date with other literature reports, we summarize the possible mechanism, reasons for misdiagnosis, radiological characteristics, surgical treatment, and postoperative management of schistosomiasis japonica cerebral granuloma, which can be used for clinical reference and to improve our knowledge of schistosomiasis japonica cerebral granuloma.

Publication types

  • Review

MeSH terms

  • Aged
  • Anthelmintics / administration & dosage
  • Anthelmintics / therapeutic use
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use
  • Brain Diseases / diagnosis
  • Brain Diseases / parasitology*
  • Brain Diseases / pathology
  • Brain Diseases / therapy
  • Granuloma / parasitology*
  • Granuloma / pathology
  • Granuloma / therapy
  • Humans
  • Male
  • Middle Aged
  • Schistosomiasis japonica / diagnosis
  • Schistosomiasis japonica / pathology*

Substances

  • Anthelmintics
  • Anti-Inflammatory Agents