Haddad Alexander F, Young Jacob S, Morshed Ramin A, Josephson S Andrew, Cha Soonmee, Berger Mitchel S
Departments of Neurological Surgery.
Neurology, and.
J Neurosurg Case Lessons. 2021 Dec 27;2(26):CASE21481. doi: 10.3171/CASE21481.
Lower-grade insular gliomas often appear as expansile and infiltrative masses on magnetic resonance imaging (MRI). However, there are nonneoplastic lesions of the insula, such as demyelinating disease and vasculopathies, that can mimic insular gliomas.
The authors report two patients who presented with headaches and were found to have mass lesions concerning for lower-grade insular glioma based on MRI obtained at initial presentation. However, on the immediate preoperative MRI obtained a few weeks later, both patients had spontaneous and complete resolution of the insular lesions.
Tumor mimics should always be in the differential diagnosis of brain masses, including those involving the insula. The immediate preoperative MRI (within 24-48 hours of surgery) must be compared carefully with the initial presentation MRI to assess interval change that suggests tumor mimics to avoid unnecessary surgical intervention.
低级别的岛叶胶质瘤在磁共振成像（MRI）上常表现为膨胀性和浸润性肿块。然而，岛叶存在一些非肿瘤性病变，如脱髓鞘疾病和血管病变，可模仿岛叶胶质瘤。
作者报告了两名出现头痛的患者，根据初次就诊时获得的MRI检查结果，发现有疑似低级别的岛叶胶质瘤的肿块病变。然而，在几周后即将进行手术前获得的MRI检查中，两名患者的岛叶病变均自发完全消退。
在包括累及岛叶的脑肿块的鉴别诊断中，始终应考虑肿瘤模仿病变。必须将即将进行手术前的MRI（手术前24 - 48小时内）与初次就诊时的MRI仔细对比，以评估提示肿瘤模仿病变的间隔期变化，避免不必要的手术干预。
