A rare case of muscular cysticercosis: Incidental discovery in a patient presenting with inguinal swelling

Muscular cysticercosis is a rare infection caused by <i>Taenia solium</i>, typically identified incidentally during imaging for unrelated symptoms. This report describes the case of a 60-year-old male who presented with a 6-month history of dull abdominal pain and swelling in the left inguinal region. The abdominal pain, initially localized to the right hypochondrium, gradually radiated to the left hypochondrium, with no known triggers or alleviating factors. The left inguinal swelling was nontender, soft, and exhibited a cough impulse. The patient had a medical history of nonmuscle invasive low-grade papillary urothelial carcinoma, treated with transurethral resection of bladder tumor (TURBT) and intravesical BCG therapy. Radiological investigations, including contrast-enhanced computed tomography (CECT) of the abdomen and pelvis, revealed multiple calcified granulomas measuring 9-10 mm in the left diaphragm, bilateral intercostal muscles, left erector muscle, right psoas muscle, and bilateral gluteal and thigh muscles. These findings were consistent with muscular cysticercosis. An X-ray AP view of the bilateral upper thighs corroborated these findings, showing multiple radiopaque soft tissue lesions in the bilateral gluteal and thigh muscles. A hypodense lesion in the spleen, measuring 12 × 8 mm, was also observed, with no evidence of malignancy. This case underscores the importance of thorough diagnostic evaluation in endemic regions, where parasitic infections such as cysticercosis may present atypically. While the patient's primary complaints were not directly related to cysticercosis, the incidental findings emphasized the value of imaging in identifying and managing such conditions. Awareness and early recognition of muscular cysticercosis are crucial to prevent complications and guide appropriate management.