Cerebral schistosomiasis masquerading as a CNS malignancy in a sudanese traveler: A diagnostic challenge and review of literature

Abstract

INTRODUCTION: Cerebral schistosomiasis is a rare condition, typically associated with Schistosoma japonicum. Cerebral involvement by S. mansoni is exceptionally uncommon and diagnostically challenging, often mimicking CNS tumors. CASE PRESENTATION: A 31-year-old Sudanese male presented with a simple partial seizure. MRI revealed a left cingulate gyrus mass suggestive of malignancy. Stereotactic biopsy showed granulomas with S. mansoni eggs, confirmed by serology despite negative stool studies. The patient received praziquantel 60 mg/kg/day and prednisolone 50 mg/day for two weeks, resulting in full symptomatic resolution and discharge. CONCLUSION: This case highlights cerebral schistosomiasis as a critical differential diagnosis for mass lesions in patients from endemic regions, emphasizing the need for early biopsy to guide appropriate therapy and avoid unnecessary surgery.