Fig 1.
Computed tomography imaging without contrast obtained at presentation.
Axial (A) and coronal (B) planes are shown. There is evidence of a round-shaped hypodense left frontal-parietal lesion (*) determining significant mass effect and no evidence of perilesional edema (arrowheads).
Fig 2.
A) Tridimensional reconstruction of the left frontal-parietal cystic lesion determining massive brain compression. B) T1 weighted Magnetic Resonance imaging, coronal section integrated by diffusion tensor imaging and 3D fiber tract reconstruction. The cystic lesion (C) compression on the left cortical-spinal tract (*) is shown in comparison to the controlateral cortical-spinal tract (**).
Fig 3.
T1 (A, C, E) and T2 (B, D, F) weighted Magnetic Resonance imaging one month after stereotactic cyst drainage (A, B) demonstrated collapse of the cystic cavity (+) and perilesional edema (asterix). Follow-up imaging after 4 weeks of corticosteroid treatment (C, D) demonstrated regression of edema and linear contrast enhancement of the surgical cavity (arrowhead). Long term follow-up (E, F), 12 months after surgery, showed complete disappearance of the lesion.
Fig 4.
Cerebral echinococcal cyst removed from the patient and used for molecular diagnosis and Echinococcus granulosus sensu lato species identification.
Fig 5.
Haplotype network of the concatenated sequence fragments (total 2,368 bp) of the genes COX1, NAD5, NAD2 and NAD1 from 13 samples of Echinococcus granulosus including cyst removed from the child (green), sheep cysts from farm A (orange) and sheep cysts from farm B (pink), and five reference sequences retrieved from E. granulosus reference mitochondrial genomes (blue) from France, Spain, Turkey (G3), Albania and Italy (G1) (GenBank Accession numbers: KY766900, KY766901, KY766903, MG672135, MG672140).