Hypothalamic neurocysticercosis as a possible cause of obesity

Abstract

We describe 2 cases of hypothalamic neurocysticerco-sis (NCC) in association with obesity. A possible central mechanism affecting regulation of alimentary ingestion secondary to NCC is suggested. We believe that such association has not been previously reported. Case reports Case 1 A 4%year-old woman was admitted to the hospital with severe abdominal pain. Physical examination showed an obese patient, bodyweight 80 kg, height 1.55 m, body mass index (BMI) 33.7 kg/m2. No data regarding any clinical history of NCC were found in the medical records. She evolved to death and autopsy revealed chronic pancreatitis and gallbladder lithiasis. The brain weighed 1180 kg, presenting a cysticercus located in the anterior hypothalamus, with intense chronic inflammatory reaction and necrosis around it.

Case 2 A 62-year-old woman, bodyweight 90 kg, height 1.53 m, BMI 38.5 kg/m*, with clinical history of diabetes mellitus, was admitted to the hospital presenting dysp-noea, sweating, and cold extremities. Physical examination revealed abdominal distension, and a periurnbilical mass. She evolved to death and an autopsy was performed showing a gallbladder adenocarcinoma infiltrating the right hepatic lobe. A cysticercus of 1-cm diameter was found compressing the third ventricle with partial hypothalamic atrophy (Figure). There were amyloid corpuscles, perivascular lymphocytic infiltrate, and neo-vessel formation around the cysticercus.

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