Neurocysticercosis among patients with cerebral gliomas
O. H. Del Brutto, P. R. Castillo, I. X. Mena and A. X. Freire
Department of Neurology, Luis Vernaza Hospital, Guayaquil, Ecuador.
BACKGROUND: Parasites have been implicated in the pathogenesis of human
cancer. Anecdotal reports have suggested an association between
neurocysticercosis and brain tumors. OBJECTIVE: To determine whether
neurocysticercosis is a risk factor for cerebral glioma. DESIGN:
Case-control study. SETTING: A university general hospital and a cancer
referral center. PATIENTS: Forty-three consecutive patients with a cerebral
glioma and 172 controls matched for age, sex, and socioeconomic status.
METHODS: We determined the ratio between the frequency of
neurocysticercosis in patients with a cerebral glioma and in matched
controls. We also evaluated differences in the characteristics of the
patients and in the histological type of the neoplasm among case patients
with and without neurocysticercosis. In addition, we noted relationships
between the location of the cerebral glioma and that of parasitic lesions.
RESULTS: Eight (16.8%) of 43 patients with a glioma and 5 (2.9%) of 172
controls had neurocysticercosis (P < .001). The odds ratio for this
association was 7.63 (95% confidence interval, 2.03-31.09). Patients with
glioma and neurocysticercosis were older than those without
neurocysticercosis (mean [+/-SD] age, 62.75 +/- 18.34 years vs 44.69 +/-
14.04 years; P = .02). Glioblastoma multiforme was more frequent among case
patients with neurocysticercosis than among those without
neurocysticercosis (87.5% vs 48.6%); however, this difference was not
statistically significant (P = .24). Six of the 8 patients with
neurocysticercosis and a cerebral glioma had calcified parasitic lesions
within and around the tumor. CONCLUSIONS: Results from this study suggest
that neurocysticercosis is a risk factor for cerebral glioma. The intense
astrocytic gliosis that surrounds calcified cysticerci, together with the
suppression of the cellular immune response induced by cysticerci, may
contribute to the development of malignant glial cells in patients with
neurocysticercosis.
