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We report the case of a 52-year-old man in whom multiple conglomerated ring-enhanced lesions in the left frontal lobe were revealed on magnetic resonance imaging (MRI); further, he presented with headache. Subtotal resection of the mass was performed and the histopathological diagnosis of gemistocytic astrocytoma was made. He received postoperative radiotherapy of remnant mass. Six months post-surgery, new multiple lesions were developed on the left cerebellum and the lesion yielded radiological findings that were quite similar to those of the lesion previously observed in the left frontal lobe. Total resection was performed with the aid of neuronavigation and a live yellow 10-cm-long worm with an active scolex was found. A pathologist identified the worm as a sparganum of Spirometra mansoni. This suggests that the live worm may have moved to the ipsilateral cerebellum due to the stimulus from the surgery and radiation on the frontal lobe. Although this case presented characteristic MRI findings of sparganosis, we did not conduct a serological test; therefore, we misdiagnosed sparganosis as gemistocytic astrocytoma. To the best of our knowledge, this is the first report of the ipsilateral transtentorial migration of cerebral sparganosis.
Emerging parasitic invasions may have a significant influence on wild and domestic animals, as well as humans worldwide. One of the possible sources of infection is the consumption of the meat of wild animals that enable infectious agents to circulate in the environment and transmit them to human and domesticated animal hosts. Human sparganosis is an emerging and neglected zoonosis worldwide. Most cases are known from Asia; however, a few cases have also been diagnosed in Europeans. Recently, in Białowieża Primeval Forest, northeastern Poland, cases of sparganosis were stated in both intermediate (raccoon dog, badger, wild boar) and definitive hosts (wolf, lynx). Confirmed presence of sparganosis in game species (wild boar) and the possibility of its occurrence in domestic animals (dogs and cats) must be taken into consideration in case this zoonosis is not routinely diagnosed by veterinarians. Plerocercoids in wild boar are located subcutaneously and in muscle tissue. Thus, the emergence of human sparganosis due to consumption of undercooked or smoked wild boar meat is very likely in the areas where wild boar is an approved food source. In this review we describe the biology of Spirometra sp. and the current knowledge about the spread of this tapeworm among wild animals as well as the risk for people, focusing on the situation in Europe.
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