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DDx for Tumor Mimics

Last Updated: February 27, 2020

This broad spectrum of conditions has a variable appearance that at times can mimic malignancy. This discussion will feature the imaging characteristics of each condition and attempt to highlight the key differentiating factors when available.

Many tumors have a variety of mimics. Here we highlight the most common broad categories of intracranial tumors: high-grade glioma, low-grade glioma, diffuse glioma, lymphoma and metastases. The mimics list for each of these tumors is by no means exhaustive but is meant to aid in the search for the patient’s true diagnosis.

High-Grade Glioma including Glioblastoma

  • Imaging
    • Heterogeneous, hyperintense mass demonstrating a thick, irregularly enhancing rim of tissue
    • Surrounding FLAIR hyperintense signal that represents either vasogenic edema or nonenhancing infiltrating tumor
    • Often has areas of necrosis and hemorrhage
    • Tumor commonly extends beyond the margins of visualized signal abnormality, often indistinguishable from surrounding nonenhancing edema
    • Often involves or crosses the corpus callosum
  • Possible Non-tumor Mimics