Cerebral tumor or pseudotumor?

D. Leclercq , S Trunet (1) , Anne Bertrand (1, 2, 3) , Damien Galanaud (1, 3) , S Lehéricy (2, 1) , Didier Dormont (2, 3, 1) , A Drier (1)

1 CHU Pitié-Salpêtrière [AP-HP]
2 ICM - Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute
3 ARAMIS - Algorithms, models and methods for images and signals of the human brain = Algorithmes, modèles et méthodes pour les images et les signaux du cerveau humain [ICM Paris]

Pseudotumoral lesions are uncommon but important to identity lesions. They can occur during inflammatory diseases (systemic diseases, vasculitis, demyelinating diseases), infectious, and vascular diseases. Also, in a patient with a treated tumor, pseudo-progression and radionecrosis must be differentiated from the tumoral development. Diagnosis can be difficult on an MRI scan, but some MRI aspects in conventional sequences, diffusion, perfusion and spectroscopy can suggest the pseudotumoral origin of a lesion. Imaging must be interpreted according to the context, the clinic and the biology. The presence of associated intracranial lesions can orientate towards a systemic or infectious disease. A T2 hyposignal lesion suggests granulomatosis or histiocytosis, especially if a meningeal or hypothalamic-pituitary involvement is associated. Non-tumoral lesions are generally not hyperperfused. In the absence of a definitive diagnosis, the evolution of these lesions, whether under treatment or spontaneous, is fundamental.

Domaines: Imagerie; Neurobiologie

D. Leclercq, S Trunet, Anne Bertrand, Damien Galanaud, S Lehéricy, et al.. Cerebral tumor or pseudotumor?. Diagnostic and Interventional Imaging, 2014, 95 (10), pp.906-16. ⟨10.1016/j.diii.2014.08.004⟩. ⟨hal-01251506⟩