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PHOTO ESSAY
Year : 2021  |  Volume : 1  |  Issue : 1  |  Page : 26-27

An unusual case of recurrent eyelid cysticercosis


Department of Ophthalmology, Government Medical College, Surat, Gujarat, India

Date of Submission23-Feb-2020
Date of Acceptance15-Jul-2020
Date of Web Publication31-Dec-2020

Correspondence Address:
Dr. Divya U Caculo
Mahalakshmi Building, Dr. Dada Vaidya Road, Panaji - 403 001, Goa
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_372_20

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  Abstract 


Keywords: Eyelid, eyelid cysticercosis, ocular cysticersosis, orbicularis oculi cysticercosis, T. solium


How to cite this article:
Patel IK, Caculo DU, Solu TM, Acharya S. An unusual case of recurrent eyelid cysticercosis. Indian J Ophthalmol Case Rep 2021;1:26-7

How to cite this URL:
Patel IK, Caculo DU, Solu TM, Acharya S. An unusual case of recurrent eyelid cysticercosis. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Mar 6];1:26-7. Available from: https://www.ijoreports.in/text.asp?2021/1/1/26/305524



Cysticercosis is the infestation by Cysticercus cellulosae, the larval form of the pork tapeworm Taenia solium.[1] The common sites for cysticerosis include the brain, eyes, and skeletal muscle.[2] Ocular cysticercosis occurs in the decreasing order of frequency in anterior orbit, subconjunctival space, posterior orbit, and the eyelid.[3]

We report a rare and unusual case of isolated recurrent lower-lid cysticercal cyst in a 14-year-old male who was operated for left lower lid swelling two months back, presented to us with asymptomatic subcutaneous cyst at the same site [Figure 1]a.
Figure 1: (a) Swelling on presentation (Preoperative). (b) Ultrasound of local part (swelling). (c) Gross specimen of the swelling. (d) Postoperative picture

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The patient to our outpatient department with the complaint of recurrence of left lower eyelid swelling since two months. On ocular examination, a swelling of 2 × 2 cm2 size was appreciated below the medial canthus left lower eyelid, which was round in shape and the overlying skin had surgical scar. On palpation, the swelling was of cystic consistency with a smooth margin, nontender, and a mobile overlying skin. Lacrimal sac syringing was normal. Ocular movements were normal in all directions of gaze and pupillary reaction was normal. There was no proptosis of eye ball. Rest ocular examination was within normal limits.

The patient had a past history of excision of the cyst from the same site two months back.

Local part ultrasonography of the eyelid [Figure 1]b swelling was suggestive of a 10 × 8 mm2 well-defined anechoic lesion with evidence of eccentric echogenic foci in the superior aspect of lesion with no intraorbital extension with a possibility of cysticercal cyst.

The patient was taken for left lower eyelid cyst excision surgery under local anesthesia. To perform this procedure, the cutaneous approach was followed with subtarsal lid crease incision. During the surgical exposure of the swelling, a cystic mass was found that was separated from the lower lid tarsal plate but was attached firmly to the orbicularis oculi muscle. The cyst then excised in toto and sent for histopathological examination.

On histopathological macro examination [Figure 1]c, a single globular structure measuring 1.5 × 1.5 × 1 cm3 was observed. On microscopic examination, the swelling showed fibroconnective tissue containing the cyst. The inner surface of the cyst showed the presence of the parasitic bladder wall of degenerated cysticercus. The overall histological features were of cysticersosis. A postoperative MRI of the brain and orbit was done which showed no abnormality. A follow up of six months showed no recurrence of the lesion [Figure 1]d.


  Discussion Top


This case highlights the need for a high degree of suspicion while surgically treating subcutaneous masses.[2] We should take utmost care during surgical removal of primary or secondary lid swellings because although postoperative inflammation is very common in cases of cysticercosis but as seen in this patient swelling can be due to the recurrence of the disease

Acknowledgement

We would like to thank the Department of Radiology and Department of Pathology, Government Medical College- Surat.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Vashisht S, Ahuja S. An unusual presentation of orbital cysticercosis. Indian J Ophthalmol 2000;48:331-2.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Rai PJ, Nair AG, Trivedi MG, Potdar NA, Gopinathan I, Shinde CA. An unusual eyelid mass of cysticercosis: A twist in the tale. J Cutan Aesthet Surg 2016;9:126-8.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Rath S, Honavar SG, Naik M, Anand R, Agarwal B, Krishnaiah S, et al. Orbital cysticercosis: Clinical manifestations, diagnosis, management, and outcome. Ophthalmology 2010;117:600-5.  Back to cited text no. 3
    


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