Lalanthica V Yogendran1, Tuba Kalelioglu2, Joseph H Donahue2, Haroon Ahmad3, Kester A Phillips4, Nicole M Calautti1, Maria-Beatriz Lopes5, Ashok R Asthagiri6, Benjamin Purow1, David Schiff1, Sohil H Patel2, Camilo E Fadul7. 1. Division of Neuro-Oncology, Department of Neurology, University of Virginia, P.O. Box 800394, Charlottesville, VA, 22908, USA. 2. Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, VA, USA. 3. Department of Neurology, University of Maryland, Baltimore, MD, USA. 4. Department of Neurology, The Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment at Swedish Neuroscience Institute, Seattle, WA, USA. 5. Department of Pathology, Divisions of Neuropathology and Molecular Diagnostics, University of Virginia, Charlottesville, VA, USA. 6. Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA. 7. Division of Neuro-Oncology, Department of Neurology, University of Virginia, P.O. Box 800394, Charlottesville, VA, 22908, USA. CEF3W@hscmail.mcc.virginia.edu.
Abstract
BACKGROUND AND OBJECTIVE: Differentiating neoplastic and non-neoplastic brain lesions is essential to make management recommendations and convey prognosis, but the distinction between brain tumors and their mimics in practice may prove challenging. The aim of this study is to provide the incidence of brain tumor mimics in the neuro-oncology setting and describe this patient subset. METHODS: Retrospective study of adult patients referred to the Division of Neuro-oncology for a presumed diagnosis of brain tumor from January 1, 2005 through December 31, 2017, who later satisfied the diagnosis of a non-neoplastic entity based on neuroimaging, clinical course, and/or histopathology evaluation. We classified tumor mimic entities according to clinical, radiologic, and laboratory characteristics that correlated with the diagnosis. RESULTS: The incidence of brain tumor mimics was 3.4% (132/3897). The etiologies of the non-neoplastic entities were vascular (35%), inflammatory non-demyelinating (26%), demyelinating (15%), cysts (10%), infectious (9%), and miscellaneous (5%). In our study, 38% of patients underwent biopsy to determine diagnosis, but in 26%, the biopsy was inconclusive. DISCUSSION: Brain tumor mimics represent a small but important subset of the neuro-oncology referrals. Vascular, inflammatory, and demyelinating etiologies represent two-thirds of cases. Recognizing the clinical, radiologic and laboratory characteristics of such entities may improve resource utilization and prevent unnecessary as well as potentially harmful diagnostic and therapeutic interventions.
BACKGROUND AND OBJECTIVE: Differentiating neoplastic and non-neoplastic brain lesions is essential to make management recommendations and convey prognosis, but the distinction between brain tumors and their mimics in practice may prove challenging. The aim of this study is to provide the incidence of brain tumor mimics in the neuro-oncology setting and describe this patient subset. METHODS: Retrospective study of adult patients referred to the Division of Neuro-oncology for a presumed diagnosis of brain tumor from January 1, 2005 through December 31, 2017, who later satisfied the diagnosis of a non-neoplastic entity based on neuroimaging, clinical course, and/or histopathology evaluation. We classified tumor mimic entities according to clinical, radiologic, and laboratory characteristics that correlated with the diagnosis. RESULTS: The incidence of brain tumor mimics was 3.4% (132/3897). The etiologies of the non-neoplastic entities were vascular (35%), inflammatory non-demyelinating (26%), demyelinating (15%), cysts (10%), infectious (9%), and miscellaneous (5%). In our study, 38% of patients underwent biopsy to determine diagnosis, but in 26%, the biopsy was inconclusive. DISCUSSION: Brain tumor mimics represent a small but important subset of the neuro-oncology referrals. Vascular, inflammatory, and demyelinating etiologies represent two-thirds of cases. Recognizing the clinical, radiologic and laboratory characteristics of such entities may improve resource utilization and prevent unnecessary as well as potentially harmful diagnostic and therapeutic interventions.
Authors: S Cha; S Pierce; E A Knopp; G Johnson; C Yang; A Ton; A W Litt; D Zagzag Journal: AJNR Am J Neuroradiol Date: 2001 Jun-Jul Impact factor: 3.825
Authors: Elizabeth H Dibble; Jerrold L Boxerman; Grayson L Baird; John E Donahue; Jeffrey M Rogg Journal: Clin Neurol Neurosurg Date: 2016-12-02 Impact factor: 1.876