Pediatric cerebral sparganosis mimicking low-grade glioma in a nonendemic region: illustrative case

Abstract

Cerebral sparganosis is a rare parasitic infection of the CNS caused by the Spirometra species. Pediatric intracranial involvement is exceptionally uncommon and has been reported predominantly from endemic regions in Asia. Preoperative diagnosis is challenging because clinical and radiological features frequently mimic neoplastic lesions. OBSERVATIONS: An 11-year-old girl presented with new-onset seizures. MRI demonstrated a small, peripherally enhancing lesion in the right parietal lobe with surrounding vasogenic edema and intralesional calcifications, initially interpreted as a pediatric low-grade glioma. The patient underwent supramarginal resection. Histopathological examination revealed inflammatory changes with parasitic structures consistent with Spirometra species. A structured review of the literature identified 77 pediatric cases, showing a modest male predominance, a mean age of 11.01 years, seizures as the most common presenting symptom, a frontal-parietal predominance of lesions, frequent preoperative misdiagnosis, and inconsistent peripheral eosinophilia. LESSONS: Pediatric cerebral sparganosis can closely mimic low-grade glioma on neuroimaging, especially in nonendemic regions. Absence of peripheral eosinophilia or a clear exposure history does not exclude the diagnosis. Awareness of this entity is critical to avoid misdiagnosis, and complete excision remains the most effective diagnostic and therapeutic strategy in tumor-like presentations. https://thejns.org/doi/10.3171/CASE264.