Brain tumour mimics on neuroimaging

There are multiple non-neoplastic lesions that can mimic intracranial neoplasms on neuroimaging. The differentiation between neoplasms and these tumour-like lesions is essential to making the correct management decisions, not least because there is significant morbidity and mortality associated with brain biopsy and surgery. It is important for us as radiologists to be aware of these conditions so we can raise this possibility and advise the clinicians about appropriate and often non-surgical expectant management. There are a variety of lesions including inflammatory, granulomatous, infective, metabolic and vascular processes that can look like a tumour. Here we present a few such pathologies along with helpful clues and specific neuroradiological features to correctly characterise them. Clinical history is also very important and sometimes a big clue to the diagnosis.