Spinal Intradural-Extramedullary Neurocysticercosis: A Case Report

Neurocysticercosis is a parasitic infection of the central nervous system (CNS) caused by the larval stage of the <i>Taenia solium</i> tapeworm. This condition is most commonly characterized by the development of cysts in the intracranial CNS, causing a wide range of neurological symptoms, such as seizures, headaches, and signs of increased intracranial pressure. Spinal intradural-extramedullary neurocysticercosis is a rare extracranial form of the disease that often resembles other conditions, such as arachnoid cysts or spinal tumors. We report the case of a 55-year-old man from Bahia, Brazil, who experienced chronic urinary retention, lower back pain, and bilateral leg tingling. Original MRI scans suggested multiple arachnoid cysts, but further imaging indicated neurocysticercosis as a possible diagnosis. The patient underwent T12-S1 laminectomy, where cystic lesions were identified and biopsied. Histopathology, posteriorly, confirmed the final diagnosis of neurocysticercosis, showing areas of necrosis and calcifications and viable parasite structures. After surgery, the patient still presented mild symptoms, such as constipation and left leg paresthesia. This case highlights the challenges of spinal neurocysticercosis diagnosis. We emphasize the importance of considering it in the differential diagnosis of spinal cystic lesions, especially in areas where the disease is common.