Abstract
We report a patient with longstanding Behçet disease who presented sudden onset of headache and facial paresis. The magnetic resonance imaging (MRI) showed a mass in the right thalamus, extending to the lentiform nucleus, subthalamic area, right cerebral peduncle and deep subcortical white matter. Stereotactic brain biopsy disclosed gliosis with no signs of malignancy. The diagnosis of a pseudotumoral form of neuro-Behçet disease was done and she was treated with pulse methylpredinisolone and intravenous cyclophosphamide. After 8 weeks she had improved and a new MRI showed disappearance of the tumor-like lesion. The differential diagnosis, especially with central nervous system tumor is emphasized.
References
Kidd D, Steur A, Denman AM, Rudge P (1999) Neurological complications in Behçet’s syndrome. Brain 122:2183–2194
Park JH, Jung MK, Bang CO, Park HK, Sung KB et al (2002) Neuro-Behçet’s disease mimicking a cerebral tumor: a case report. J Korean Med Sci 17:718–722
Çoban O, Bahar S, Akman-Demir G et al (1999) Masked assessment of MRI findings: is it possible to differentiate neuro-Behçet’s disease from other central nervous system disease. Neuroradiology 41:225–260
Kataoka S, Hirose G, Tsukada K (1989) Brain stem type neuro-Behçet’s syndrome. Correlation of enhanced CT scans and MRI during the acute and chronic stage of the illness. Neuroradiology 39:258–262
Kermode AG, Plant GT, Mac Manus DG et al (1989) Behçet’s disease with slowly enlarging midbrain mass on MRI: resolution following steroid therapy. Neurology 39:1251–1252
Al Khawi MZ, Bohlega S, Banna M (1991) MRI findings in neuro-Behçet’s disease. Neurology 41:405–408
Banna M, El-Ramahi K (1991) Neurologic involvement in Behçet’s disease: imaging findings in 16 patients. AJNR 12:791–796
Wechsler B, Dell Isola B, Vidailhet M et al (1993) MRI in 31 patients with Behçet’s disease and neurological involvement: prospective study with clinical correlation. J Neurol Neurosurg Psychiatry 56:793–798
Morrisey SP, Miller DH, Hermaszewski R et al (1993) MRI of the central nervous system in Behçet’s disease. Eur Neurol 33:287–293
Tali E, Atilla S, Keskin T et al (1997) MRI in neuro-Behçet’s disease. Neuroradiology 39:2–6
Miller DH, Omerod IEC, Gibson A et al (1987) MR brain scanning in patients with vasculitis: differentiation from multiple sclerosis. Neuroradiology 29:226–231
Willeit J, Schmutzhard E, Aichner F, Mayr U, Weber F, Gerstenbrand F (1986) CT and MR imaging in neuro-Behçet disease. J Comput Assist Tomogr 10:313–315
Mitsui Y, Mitsui M, Urakami R, Kihara M, Takahashi M, Kusunoki S (2005) Behçet disease presenting with neurological complications immediately after conversion from conventional cyclosporine A to microemulsion formulation. Intern Med 44:149–152
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Appenzeller, S., de Castro, R., Queiroz, L.d.S. et al. Brain tumor-like lesion in Behçet disease. Rheumatol Int 26, 577–580 (2006). https://doi.org/10.1007/s00296-005-0082-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-005-0082-3