Ring-Enhancing Cystic Lesions: Infectious Mimicry of High-Grade Brain Tumors – A Neuroradiological Perspective


Authors : Dr. Sahithy Kakkireni; Dr. Pradeepgoud H Patil; Dr. Virupaxi Hattiholi

Volume/Issue : Volume 10 - 2025, Issue 3 - March

Google Scholar : https://tinyurl.com/23jzjsdf

Scribd : https://tinyurl.com/mr4ah645

DOI : https://doi.org/10.38124/ijisrt/25mar478

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Abstract : Ring-enhancing cystic brain lesions are often associated with infectious diseases such as neurocysticercosis (NCC) or fungal infections. However, in some cases, these lesions mimic high-grade neoplasms such as glioblastoma (GBM) or metastatic tumors. This article presents two cases in which patients were initially diagnosed with infectious brain lesions based on imaging findings, but histopathological analysis confirmed malignant tumors. Through a detailed discussion of advanced imaging techniques and diagnostic pitfalls, this study emphasizes the critical role of histopathological confirmation in differentiating infectious from neoplastic brain lesions.

Keywords : Ring-Enhancing Lesions, Neurocysticercosis, Glioblastoma, Metastatic Adenocarcinoma, Advanced Neuroimaging, Histopathology, SWI, Spectroscopy, DSC Perfusion MRI, Arterial Spin Labeling.

References :

  1. Osborn, A. G. (2017). Osborn's Brain: Imaging, Pathology, and Anatomy. Elsevier.
  2. Kim, J. H., et al. (2018). Advanced MR imaging in the differentiation of brain abscesses and cystic or necrotic brain tumors. Neuroimaging Clinics of North America, 28(4), 567-582.
  3. Hakyemez, B., et al. (2006). High-grade and low-grade gliomas: Differentiation by using perfusion MR imaging. Clinical Radiology, 61(11), 907-920.
  4. Gupta, R. K., et al. (2001). Differentiation of tuberculomas from neurocysticercosis using proton MR spectroscopy. AJNR American Journal of Neuroradiology, 22(8), 1593-1599.
  5. Lummel, N., et al. (2011). Diffusion-weighted MR imaging in ring-enhancing brain lesions: The role of ADC values and histopathologic findings. AJNR American Journal of Neuroradiology, 32(9), 1632-1638.

Ring-enhancing cystic brain lesions are often associated with infectious diseases such as neurocysticercosis (NCC) or fungal infections. However, in some cases, these lesions mimic high-grade neoplasms such as glioblastoma (GBM) or metastatic tumors. This article presents two cases in which patients were initially diagnosed with infectious brain lesions based on imaging findings, but histopathological analysis confirmed malignant tumors. Through a detailed discussion of advanced imaging techniques and diagnostic pitfalls, this study emphasizes the critical role of histopathological confirmation in differentiating infectious from neoplastic brain lesions.

Keywords : Ring-Enhancing Lesions, Neurocysticercosis, Glioblastoma, Metastatic Adenocarcinoma, Advanced Neuroimaging, Histopathology, SWI, Spectroscopy, DSC Perfusion MRI, Arterial Spin Labeling.

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