Orbital cysticercosis. Case report, clinical and histological findings andreview of the literature

Background: The differential diagnosis of painless orbital swelling is comp lex and based on radiological and physical examination as well as laborator y tests. Due to increasing tourism to exotic countries a thorough history i s important to observe diseases which are rare in industrialised countries but frequent in developing countries. Patient: A 30-year-old man complained about a painless orbital swelling in the absence of general symptoms. Orbital examination revealed a normal glob e. MRI scan and B-scan ultrasounds showed an orbital cyst with a diameter o f 1 cm. The patient's history disclosed lengthy travel to India as well as South East Asia. Results: Histopathological examinations following excision of a whitish int raorbital mass showed a cream-white, thin walled cyst with a single central invaginated scoter with suckers and hooklets. This finding is characterist ic for cysticercosis. Conclusions: Cysticercus cellulosae is the larval stage of the pork tapewor m Taenia solium. It is transmitted by ingestion of contaminated food or wat er. Ocular affection is reported concerning the vitreous or subretinal loca lisation, less often in the anterior segment, subconjunctiva or orbita. Esp ecially after trips to tropical regions, parasitic diseases should be kept in mind when dealing with unusual eye symptoms. Besides cysticercosis there are e.g. echinococcosis, onchocercosis (river blindness) and infections wi th toxocara or Loa loa.