Sir, a 16-year-old female, who was originally from East Timor, presented at the Oral Surgery Department of the Royal Victoria Hospital in Belfast, having moved to Northern Ireland when she was 7 years old. She had been referred by her general medical practitioner regarding a lump in her lower lip. This was painless, and had been present for approximately 9 years with no fluctuation in size noticed by the patient. She had no relevant past medical history.

Examination revealed a well circumscribed submucosal swelling at the inner aspect of the left side of her lower lip, which was approximately 1 cm in diameter. The lump was firm in texture with normal overlying mucosa, and appeared blue in colour when pressed towards the mucosal surface of the lip. No other abnormalities were noted.

The lesion was excised under local anaesthetic. Histopathological examination revealed a cysticercus cyst consistent with a cestode (tapeworm) parasitic infection, following the ingestion of tapeworm eggs (Fig. 1). The patient was referred to the infectious diseases department of the hospital, whereupon in light of the fact that she displayed no other manifestations of tapeworm infection she was discharged without further intervention but advised to recontact if further symptoms arose. Her lip healed well, and she was also discharged from the Oral Surgery Department.

Figure 1
figure 1

Histopathological appearance of lesion

Full size image

Cysticercosis is particularly prevalent in Latin America, sub-Saharan Africa, and Southeast Asia but the incidence in western countries is rising in line with increased international travel and immigration.1,2 The likelihood is that this patient contracted the condition before she moved to Northern Ireland. We can find no previous reports of cysticercosis affecting the oral cavity being diagnosed in this country.

We would like to highlight the possibility of cysticercosis as a differential diagnosis when considering oral submucosal swellings, particularly in patients who have lived in areas of the world where the condition is prevalent.