Abstract
Neurocysticercosis (NC), a parasitic infection caused by Taenia solium, is an increasingly recognized cause of seizures in the United States, particularly among individuals from endemic regions. This report describes a diagnostically challenging case of a 51-year-old Vietnamese woman who presented with new-onset seizures and was initially treated for NC following craniotomy. Despite antiparasitic therapy, persistent symptoms and progressive imaging changes prompted further intervention, ultimately revealing a metastatic ovarian serous adenocarcinoma adjacent to the prior NC lesion. This rare instance of collision metastases, with an uncommon instance of ovarian cancer metastasizing to active NC, underscores the complexity of differentiating NC from neoplastic disease, emphasizing the need for a broad differential in patients with intracranial lesions and risk factors for both infectious and malignant processes.