Autochthonous Neurocysticercosis Brain Lesions Mimicking Metastatic Disease, Spain

In 2025, a case of autochthonous neurocysticercosis was diagnosed in a 60-year-old man in Spain without travel history. The patient presented with a two-week progressive headache and behavioral changes. Initial brain imaging revealed multiple lesions mimicking metastases, but extensive oncologic workup found no primary malignancy. Magnetic resonance imaging demonstrated numerous cystic lesions with characteristic features of cysticercosis including scolices. Diagnosis was confirmed by positive serology for Taenia solium antibodies. The patient was successfully treated with albendazole and praziquantel. The case emphasizes that autochthonous transmission of cysticercosis is exceptionally rare in Western Europe, with only 18 confirmed cases identified during 1990-2011.