BACKGROUND- Certain central nervous system (CNS) lesions can be misconstrued histopathologically as high-grade or aggressive neoplasms when they are, in fact, low-grade processes for which surgery alone may be adequate therapy. Reactive lesions such as demyelinating disease can be misinterpreted as well and when diagnosed as a glioma, may be treated with radiotherapy. Complications of treatment, e.g., radionecrosis, are fostered by the long post-therapy survival periods permitted by low-grade neoplasms and, especially, nonneoplastic entities. REVIEW SUMMARY- As a benchmark against which any diagnosis of a CNS tumor should be reconciled is a set of neuroradiological findings that usually indicate a low-grade neoplasm or a reactive nonneoplastic entity. These eight specific radiological features are illustrated in the context of representative low-grade or nonneoplastic CNS lesions. CONCLUSIONS- An interdisciplinary approach, with reconciliation of any discrepancies between neuroimaging features and the pathological diagnosis, can minimize the possibility that patients with suspected CNS tumors will be overtreated.
ASJC Scopus subject areas
- Clinical Neurology