Differential Diagnosis of Tumor-like Brain Lesions
Gina S. Perez Giraldo, Lauren Singer, Toni Cao, Pouya Jamshidi, Karan Dixit, Marinos Kontzialis, Rudolph J. Castellani, Peter Pytel, Nidhiben Anadani, Carolyn Bevan, Elena Grebenciucova, Roumen Balabanov, Bruce A. Cohen, Edith L. Graham
Abstract
Purpose of Review: Tumor-like brain lesions are rare and commonly suggest a neoplastic etiology. Failure to rapidly identify non-neoplastic causes can lead to increased morbidity and mortality. In this review, we describe 10 patients who presented with atypical, non-neoplastic tumor-like brain lesions in which brain biopsy was essential for a correct diagnosis and treatment. Recent Findings: There has been increasing recognition of autoimmune conditions affecting the nervous system, and many of those diseases can cause tumor-like brain lesions. Currently available reports of non-neoplastic tumor-like brain lesions are scarce. Most case series focus on tumefactive demyelinating lesions, and a comprehensive review including other neuroimmunological conditions such as CNS vasculitis, neurosarcoidosis, histiocytic and infectious etiologies is lacking. Summary: We review the literature on tumor-like brain lesions intending to increase the awareness and differential diagnosis of non-neoplastic brain tumor mimics. We advocate for earlier brain biopsies, which, in our case series, significantly changed diagnosis, management, and outcomes.