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CASE REPORT phonuclear cells. The reaction is attributed to a
hypersensitivity reaction to leaked cystic fluid. Rupture
A 28 year old healthy man from La Union suddenly of the cyst exites a more pronounced inflammatory
noticed a slowly growing nodule over the neck for reaction, characterized by fibroblastic proliferation and
the past five years. On consultation in February 1990, giant cell and granuloma formation, eventuating in
the local finding was a firm, non-tender tumor, focal granulomas followed by calcification.
approximately 1.0 x 1.0 cm in size, along the right _\
antero-lateral aspect of the neck, at the level of the By eating infected pig meat ("measly po_") man
cricoid cartilage, free from skin, however, apparently completes the life cycle and the cysticerci can _velop
attached to the underlying muscle. There were no into adult intestinal tapeworms.
other accompanying signs and symptoms. Complete
blood count (CBC) and chest x-ray were both normal. Man may replace the pig as the intermediate host
Routine stool tests for parasites were likewise nega- by two means: (1) by oral consumption of fecally
tive. The tentativediagnosis was a nonspecific swelling contaminated food that contains proglottids or eggs
of the lymph node. The small nodular mass along or (2) by intestinal auto-infection from reverse
the stemocleidomastoid muscle was removed. The peristalsis, with the introduction of proglottids into
hispathological examination showed Cysticercosis the stomach where hatching commences.
cellulosae. Repeated stool tests gave negative find-
_ ings for Taenia. No medications were prescribed, Human cysticercosis can involve multiple organ
however, patient was informed of hygienic and systems. The clinical features are extremely variable
prophylactic measures. Pertinent personal history and depend on the location and number of cysticerci
revealed that the patient is a heavy smoker and drinker, into the host. Light humaninfestations, the result of
With a craving for "Kilawin" or raw spiced meat or swallowing a few eggs, may escape unnoticed unless
fish on every drinking spree, a cyst is so located as to cause physical signs. Heavy
infestations with hundreds of cysticerci cause very
grave manifestations chiefy due to the presence of
DISCUSSION cysterci in the central nervous system. When alive,
these parasites rarely cause trouble, but they begin
Very few reports exists concerning manifestation to die and degenerate within three to five years.
of cysticercosis in the otolaryngological field, and this
disease is not mentioned in standard textbooks of The larvae at first may cause a local, surrounding,
otolaryngology, inflammatory reaction with infiltration by neutrophils
and lymphocytes, and a stimulation to fibroblast
In the life cycle of Taenia solium, man is primary production.
host. As the tape worm growns in the human intestinal
tract, proglottids (segments filled with eggs) Subsequently, the larvae become enclosed within
detach from the adults and are passed with the feces a fibrous capsule, or necrosis may occur, followed
into the environment. The domestic pig is the only by caseation or calcification which often times can
significant intermediate host; it becomes infected when be seen on roentogenologic study. Sections may show
it eats the food contaminated by proglottid-contain- the hooks and suckers in the scoltex or the intestinal
ing feces. Ingested eggs hatch in the pig's stomach structures in the body of the parasite.
and duodenum, where they penetrate the intestinal
epithelium. The rarity of this parasitic infection, along with
the constitutional symptoms it presents, has beeen the
Vascular and lymphatic invasion allows a wide reason for its poor documentation. There have been
distribution of the larvae to various tissues. The larvae very few reports regarding Cysticercosis worldwide,
may localize in any site in the body such as skin, more so, its head. and neck manifestations.
subcutaneous tissue, skeletal muscle, heart, brain, liver, In a limited study done from 1970-1980 in Latin
lungs and the eyes. The larvae develop within the America, a predominance of brain and ocular involvetissues
into small, thin, translucent cysts. The cyst ment is presented. It is further emphasized that
evokes an inflammamtory reaction which is charac- muscular involvement ranks second to last and the
terized by large numbers of eosinophils and polymor- neck taken as a single entity may even be a more
minute fraction.
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