Differentiation of Tumefactive Demyelinating Lesions from Metastatic Brain Disease with FDG PET-CT: A Case Report

Tumefactive demyelinating brain disease can pose a diagnostic challenge in patients without a pre-existing diagnosis of multiple sclerosis by mimicking intra-cranial neoplasms, infarction, as well as infections. Choosing when to biopsy a tumefactive lesion to exclude alternative pathology can be difficult. Here we report a case of a 44 year old female patient without a previous history of multiple sclerosis who presented with two brain lesions mimicking metastatic brain disease which pose a serious diagnostic dilemma. FDG PET CT and follow up magnetic resonance imaging (MRI) helped to rule out tumor etiology of those lesions and spared patient from invasive procedures such as biopsy or radiotherapy.