Pseudotumoral neuro-Behçet's disease

Area of Science:

• Neurology
• Neuroimmunology
• Neuro-oncology

Background:

• Neuro-Behçet's disease (NBD) is a rare systemic vasculitis affecting the central nervous system.
• Pseudotumoral presentations of NBD can mimic brain tumors, complicating diagnosis, especially in the absence of characteristic mucocutaneous or ocular findings.

Observation:

• A young patient presented with acute right hemiparesis.
• Computed tomography (CT) revealed a thalamocapsular lesion with features suggestive of an expanding mass.
• Brain biopsy was performed, ruling out malignancy but yielding no specific diagnosis.

Findings:

• The patient exhibited a pseudotumoral presentation of Neuro-Behçet's disease.
• Diagnostic challenges were encountered due to the lack of typical NBD clinical signs.
• Histopathological examination of the brain biopsy did not provide a definitive etiological diagnosis.

Implications:

• This case highlights the importance of considering NBD in the differential diagnosis of brain tumors, particularly in young individuals with focal neurological deficits and suggestive imaging.
• The successful response to steroid therapy suggests its potential role in managing pseudotumoral NBD, even when the diagnosis is initially unclear.
• Further research is warranted to improve diagnostic strategies and treatment protocols for pseudotumoral NBD.