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Pyogenic brain abscess with atypical features resembling glioblastoma in advanced MRI imaging

Arsany Hakim1, Markus Oertel2, Roland Wiest1

  • 1University institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 10, CH-3010 Bern, Switzerland.

Radiology Case Reports
|May 12, 2017
PubMed

Insights

Distinguishing infectious from neoplastic brain lesions can be challenging. Advanced MRI techniques aided in diagnosing brain abscesses that mimicked glioblastoma in an autistic patient.

Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Accurate differentiation between infectious and neoplastic brain lesions is critical for effective treatment planning.
  • Advanced magnetic resonance imaging (MRI) techniques, including diffusion, perfusion, and susceptibility-weighted imaging, improve diagnostic capabilities.
  • However, atypical presentations can still pose diagnostic challenges.

Observation:

  • A case study involving an autistic patient with multiple brain lesions is presented.
  • The lesions exhibited imaging characteristics on diffusion-weighted imaging, susceptibility-weighted imaging, and perfusion MRI that resembled multicentric glioblastoma.
  • Surgical, neuropathological, and bacteriological confirmation revealed the lesions to be brain abscesses.

Findings:

  • The imaging findings initially suggested a neoplastic process, specifically glioblastoma.
  • Despite advanced MRI techniques, the presentation mimicked a malignant tumor.
  • The definitive diagnosis of brain abscesses was established through comprehensive pathological and microbiological analysis.

Implications:

  • This case highlights the importance of considering infectious etiologies even with advanced imaging findings suggestive of neoplasia.
  • Advanced MRI techniques are valuable but may require integration with clinical context for complex cases.
  • Understanding atypical presentations is crucial for accurate diagnosis and appropriate management of brain pathologies.
Keywords:
DiffusionInfectiousNeoplasticPerfusionSusceptibility

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