Pseudotumoral lesion: Pathology and follow-up

Abstract

A 34-year-old woman arrived at our hospital’s emergency department with 1 week of progressive and oppressive occipital headache, associated with photophobia, nausea and vomiting, and right-sided brachio-crural paresis. At physical examination she had expressive aphasia and moderate right-sided hemiparesis. There were no particular findings in her basic blood exams. Magnetic resonance imaging (MRI) showed a hypointense T1 and hyperintense T2 left frontotemporoparietal expansive lesion with mass effect, partially collapsing the ipsilateral ventricle with a midline shift (Fig. 1a, b). Furthermore, MRI showed a perilesional brain edema, but no enhancement with gadolinium. There was no restriction of diffusion and no other lesions were present. Given the diagnostic impression of a neoplastic process, she was admitted as an inpatient and a whole body CT scan, broader laboratory tests, including an HIV serology, mammography and mammary echography were ordered...