Doctors find tapeworm in a woman’s brain as they performed brain surgery to take out a tumor. Rachel Palma was in shock when she received the news that the lesion on her brain was a suspected tumor. He scans also suggested that it was cancerous. The newly married Palma on receiving the news said she was in shock and unwilling to believe it was true.
In September, scrubbed-up doctors and surgeons commenced the operation at Mount Sinai Hospital, New York City. They opened Ms. Palma’s cranium and steeled themselves for a malignant brain tumor, said Jonathan Rasouli, Chief neurosurgery resident at the Icahn School of Medicine at Mount Sinai. But instead, Dr. Rasouli said, they saw an encapsulated mass resembling a quail egg.
“We were all saying, ‘What is this?’” Dr. Rasouli recalled in a phone interview with The Washington Post. “It was very shocking. We were scratching our heads, surprised at what it looked like.”
The extract from Ms. Palma’s brain was placed under the microscope for a close look. Then they sliced into it and found a baby tapeworm. Ms. Palma said she had mixed feelings about it.
“Of course, I was grossed out,” the 42-year-old said, explaining that no one wants to think there is a tapeworm growing inside an egg in their brain. “But of course, I was also relieved. It meant that no further treatment was necessary.”
Ms. Palma said she had long been struggling with insomnia and, when she could sleep, nightmares. She said she had also experienced hallucinations, imagining that things were happening when they were not.
By January 2018, her symptoms had worsened. Ms. Palma said she started having trouble holding things, such as her coffee mug, which she inadvertently dropped on the floor.
She started having trouble texting people, so she resorted to calling them.
She started experiencing confusion – locking herself out of the house, showing up for work without her uniform and staring at her computer screen, unable to make sense of the words. At one point, she said, she called her parents and left a message on their answering machine, explaining that the place where she had bought her bed years ago suddenly wanted it back.
After several doctor’s appointments and trips to the emergency room, Ms. Palma ended at Mount Sinai hospital. The hospital identifies a lesion on her left frontal lobe, near a speech center. They said from the shape and the way it appeared on the MRI exam led doctors to a grim conclusion* brain cancer.
However, upon inspection, Dr. Rasouli said it was “clearly not a brain tumor”. Ms. Palma was diagnosed with neurocysticercosis, a parasitic infection in the brain caused by the tapeworm.
Bobbi Pritt, director of the Clinical Parasitology Laboratory in the Mayo Clinic’s Department of Laboratory Medicine and Pathology, said Taenia solium is not common in the US but, when people do become infected, the parasite can present in two different forms. The most common form, she said, is the adult tapeworm, which is ingested from undercooked pork and lives in the gut.
But there is another, less common way to get the parasite.
People who have the adult form shed microscopic eggs in their stool and, if they do not properly wash their hands, they can pass on the tapeworm to others, Dr. Pritt said.
For example, Dr. Pritt said, if the person who has the adult tapeworm gets the eggs on his or her hands and then prepares another person’s food, that other person can unknowingly eat the eggs. She said the eggs then travel to the small intestine, hatch into larvae, penetrate the bowel wall and get into the bloodstream, where they can migrate throughout the entire body, including the brain.
The larval form appears as a fluid-filled cyst, Dr. Pritt added.
Dr. Pritt said the adult form is treated with an anti-parasitic medication, but treatment for the larval form can be complex and depends on the location and stage of infection.
“I want people to understand that this was such a rare occurrence,” Ms. Palma said about the tapeworm that was in her brain. “Every headache is not going to be a parasite.”
Ms. Palma said her symptoms have subsided “almost 100 percent”.
“The best part of my story is it has a happy ending,” she said.