Cerebral Neoplasms

  • Edmond A. Knopp
  • Girish M. FatterpekarEmail author


A mass-like lesion in the brain always makes us consider the possibility of an underlying tumor. We then assess the imaging pattern in order to establish an appropriate tumoral differential diagnosis. While this approach often works, a mass lesion can sometimes simulate a tumor. Identification of such a tumor mimic is essential since it can significantly influence further management. This review article will focus on imaging features of brain tumors and tumor mimics. Considering the exhaustive list of tumors (intra-axial, calvarial/dural based, sellar based, pineal region based, and intraventricular), we will limit our discussion to intra-axial tumors.


Glioblastoma Pseudoprogression Pseudoresponse Gliomatosis cerebri Astrocytoma Oligodendroglioma Lymphoma Metastases Medulloblastoma Tumefactive demyelinating lesion 


  1. 1.
    Koeller KK, Rushing EJ (2004) From the archives of AFIP: pilocytic astrocytoma: radiologic pathologic correlation. Radiographics 24:1693–1708CrossRefPubMedGoogle Scholar
  2. 2.
    Linscott LL, Osborn AG, Blaser S et al (2008) Pilomyxoid astrocytoma: expanding the imaging spectrum. AJNR Am J Neuroradiol 29:1861–1866CrossRefPubMedGoogle Scholar
  3. 3.
    Crespo-Rodriguez AM, Smirniotopoulos JG, Rushing EJ (2007) MR and CT imaging of 24 pleomorphic xanthoastrocytomas (PXA) and a review of the literature. Neuroradiology 49:307–315CrossRefPubMedGoogle Scholar
  4. 4.
    Koeller KK, Henry JM (2001) From the archives of AFIP: superficial gliomas: radiologic-pathologic correlation. Radiographics 21:1533–1536CrossRefPubMedGoogle Scholar
  5. 5.
    Al-Okaili RN, Krejza J, Woo JH et al (2007) Intra-axial brain masses: MR imaging-based diagnostic strategy – Initial experience. Radiology 243:539–550CrossRefPubMedGoogle Scholar
  6. 6.
    Law M, Yang S, Wang H et al (2003) Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol 24:1989–1998PubMedGoogle Scholar
  7. 7.
    Felsberg GJ, Silver SA, Brown MT et al (1994) Radiologic-pathologic correlation: gliomatosis cerebri. AJNR Am J Neuroradiol 15:1745–1753PubMedGoogle Scholar
  8. 8.
    Spagnoli MV, Grossman RI, Packer RJ et al (1987) Magnetic resonance imaging determination of gliomatosis cerebri. Neuroradiology 29:15–18CrossRefPubMedGoogle Scholar
  9. 9.
    Cha S, Lupo JM, Chen MH et al (2007) Differentiation of glioblastoma multiforme and single brain metastasis by peak height and percentage of signal intensity recovery derived from dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging. AJNR Am J Neuroradiol 28:1078–1084CrossRefPubMedGoogle Scholar
  10. 10.
    Jenkinson MD, du Plessis DG, Smith TS et al (2006) Histological growth patterns and genotype in oligodendroglial tumours: correlation with MRI features. Brain 129:1884–1891CrossRefPubMedGoogle Scholar
  11. 11.
    Koeller KK, Rushing EJ (2005) From the archives of the AFIP. Oligodendroglioma and its variants: radiologic-pathologic correlation. Radiographics 25:1669–1688CrossRefPubMedGoogle Scholar
  12. 12.
    Engelhard HH, Stelea A, Mundt A (2003) Oligodendroglioma and anaplastic oligodendroglioma: clinical features, treatment, and prognosis. Surg Neurol 60:443–456CrossRefPubMedGoogle Scholar
  13. 13.
    Giannini C, Burger PC, Berkey BA et al (2008) Anaplastic oligodendroglial tumors: refining the correlation among histopathology, 1p 19q deletion and clinical outcome in Intergroup Radiation Therapy Oncology Group Trial 9402. Brain Pathol 18:360–369CrossRefPubMedGoogle Scholar
  14. 14.
    van den Bent MJ (2007) Anaplastic oligodendroglioma and oligoastrocytoma. Neurol Clin 25:1089–1093CrossRefPubMedGoogle Scholar
  15. 15.
    Shin JH, Lee HK, Khang SK et al (2002) Neuronal tumors of the central nervous system: radiologic findings and pathologic correlation. Radiographics 22:1177–1189CrossRefPubMedGoogle Scholar
  16. 16.
    Castillo M, Davis PC, Takei Y et al (1990) Intracranial ganglioglioma: MR, CT, and clinical findings in 18 patients. AJR Am J Roentgenol 154:607–612CrossRefPubMedGoogle Scholar
  17. 17.
    Zenter J, Wolf HK, Ostertun B et al (1994) Gangliogliomas: clinical, radiological, and histopathological findings in 52 patients. J Neurol Neurosurg Psychiatry 57:1497–1502CrossRefGoogle Scholar
  18. 18.
    Campos AR, Clusmann H, von Lehe M et al (2009) Simple and complex dysembryoplastic neuroepithelial tumors (DNT) variants: clinical profile, MRI, and histopathology. Neuroradiology 51:433–443CrossRefPubMedGoogle Scholar
  19. 19.
    Stanescu Cosson R, Varlet P, Beuvon F et al (2001) Dysembryoplastic neuroepithelial tumors: CT, MR findings and imaging follow-up: a study of 53 cases. J Neuroradiol 28:230–240PubMedGoogle Scholar
  20. 20.
    Koeller KK, Rushing EJ (2003) Medulloblastoma: a comprehensive review with radiologic-pathologic correlation. Radiographics 23:1613–1637CrossRefPubMedGoogle Scholar
  21. 21.
    Rumboldt Z, Camacho DL, Lake D et al (2006) Apparent diffusion coefficients for differentiation of cerebellar tumors in children. AJNR Am J Neuroradiol 27:1362–1369PubMedGoogle Scholar
  22. 22.
    Han L, Qiuu Y, Xie C et al (2010) Atypical teratoid/rhabdoid tumors in adult patients: CT and MR imaging features. AJNR Am J Neuroradiol 32:103–108PubMedGoogle Scholar
  23. 23.
    MacDonald TJ, Rood BR, Santi MR et al (2003) Advances in diagnosis, molecular genetics, and treatment of pediatric embryonal CNS tumors. Oncologist 8:174–186CrossRefPubMedGoogle Scholar
  24. 24.
    Erdag N, Bhorade RM, Alberico RA et al (2001) Primary lymphoma of the central nervous system: typical and atypical CT and MR imaging appearances. AJR Am J Roentgenol 176:1319–1326CrossRefPubMedGoogle Scholar
  25. 25.
    Cha S, Pierce S, Knopp EA et al (2001) Dynamic contrast-enhanced T2*-weighted MR imaging of tumefactive demyelinating lesions. AJNR Am J Neuroradiol 22:1109–1116PubMedGoogle Scholar
  26. 26.
    Dagher AP, Smirniotopoulos J (1996) Tumefactive demyelinating lesions. Neuroradiology 38:560–565CrossRefPubMedGoogle Scholar
  27. 27.
    Savoiardo M, Erbetta A, Storchi G et al (2010) Case 159: cerebral amyloid angiopathy-related inflammation. Radiology 256:323–327CrossRefPubMedGoogle Scholar
  28. 28.
    Kocer N, Islak C, Siva A et al (1999) CNS involvement in neuro-Behcet syndrome. AJNR Am J Neuroradiol 20:1015–1024PubMedGoogle Scholar
  29. 29.
    Stupp R, Mason WP, van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996CrossRefPubMedGoogle Scholar
  30. 30.
    Fatterpekar GM, Galheigo D, Narayana A et al (2012) Treatment-related change versus tumor recurrence in high-grade gliomas: a diagnostic conundrum – use of dynamic susceptibility contrast-enhanced (DSC) perfusion MRI. AJR Am J Roentgenol 198:19–26CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.RadiologyZwanger-Pesiri RadiologyLindenhurstUSA
  2. 2.RadiologyNYU School of MedicineNew YorkUSA

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