Brain pseudotumour secondary to Behçet’s disease

Abstract

Neuro-Behçet’s disease (NBD) is a serious manifestation of Behçet’s disease (BD) and can affect either the central or peripheral nervous systems, or both. It occurs in 10–50% of patients with BD. We report on a patient with an unusual intraparenchymal lesion, initially thought to be a brain tumour. Histological examination revealed vasculitis consistent with BD. Clinicians should include NBD as a differential diagnosis when considering an isolated inflammatory intracranial lesion.

Neuro-Behcet’s Presenting as a Tumefactive Brainstem Mass

“…2,3 .Tumefactive NBD is rare and has only been reported a handful of times. [2][3][4][5][6] Imaging in tumefactive NBD demonstrates areas of T2 hyperintensity and diffuse contrast enhancement suggesting edema; consistent with our patient's imaging. 7 The main radiologic differential includes glial lymphomas, or infectious and granulomatous lesions.…”

Neuro-Behçet’s disease revealed by diencephalo-mesencephalic impairment

“…Mesencephalo-diencephalic lesions are often bilateral and asymmetrical, with contrast uptake in the initial phase [4,5]. The differential diagnoses being mainly tumoral (glioblastomas or lymphomas) or infectious (tuberculous abscess) [5,6].…”

“…Indeed, telencephalic venous drainage occurs in two directions, through the existence of multiple anastomoses between the superficial, pial veins, and the basilar vein of Rosenthal. In the brainstem, these anastomoses are rarer [6,9,10].…”

“…In the pseudotumor forms, the lesions appear in hyposignal in T1 and in hypersignal in T2 with significant vasogenic edema and peripheral contrast uptake after injection of gadolinium [6,15].…”