Cutaneous Cysticercosis Mimicking an Epidermal Inclusion Cyst: A Rare Case

TL;DR

A rare case of cutaneous cysticercosis was mistaken for a benign skin cyst, highlighting the need for thorough diagnosis in endemic areas.

Contribution

This case adds to the limited literature on isolated cutaneous cysticercosis and emphasizes the importance of histopathology in diagnosis.

Findings

Cutaneous cysticercosis can mimic benign skin lesions like epidermal inclusion cysts.

Histopathological evaluation is crucial for accurate diagnosis of subcutaneous swellings in endemic regions.

The case involved a 23-year-old male with no systemic disease after surgical excision of the lesion.

Abstract

Cutaneous cysticercosis is a rare clinical manifestation of the larval stage of Taenia solium infection. While neurocysticercosis is the most commonly reported form, subcutaneous presentations are often overlooked or misdiagnosed due to their asymptomatic, benign, and cyst-like appearance. The parasite’s ability to mimic common dermatologic lesions, including lipomas or epidermal inclusion cysts, complicates timely diagnosis. This underscores the importance of thorough evaluation, especially in endemic regions, and highlights the utility of histopathological and imaging studies. A 23-year-old immunocompetent male presented with a two-week history of a painless, cystic swelling over the right subcostal region, without signs of inflammation or discharge. Ultrasound of the superficial soft tissue revealed a well-circumscribed cystic lesion suggestive of an epidermal inclusion cyst. Surgical excision of the 0.5 × 1 cm bean-shaped swelling was performed. Histopathological evaluation unexpectedly revealed the presence of a parasitic cyst consistent with cutaneous cysticercosis. The patient was clinically evaluated and found to have no further evidence of systemic disease. Cutaneous cysticercosis, although rare and often clinically silent, must be included in the differential diagnosis of subcutaneous swellings in endemic regions. This case emphasizes the role of imaging and histopathology in distinguishing parasitic infections from benign skin lesions and adds to the limited literature on isolated cutaneous forms.

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