Case 131. Soap bubble sign in cerebral paragominiasis

　 　 　 　
　 Head roentgenograph demonstrates a large, demarcated frontal lobe lesion with bubbly appearance. Calcification is discerned. Allegedly, the soap bubble sign is suggestive of paragonimiasis westermani. 　
　 　 　 　

　

 　 Brain metastasis of P. westermani leads to serious CNS symptoms. Infection is mediated by eating raw Japanese mitten crab (Eriocheir japonica de Haan) carrying metacercaria.