Differential Diagnosis of Intracranial Masses

The differential diagnosis of cerebral mass lesions includes neoplastic, inflammatory, infective, and vascular lesions, as well as incidental developmental anomalies. A differential diagnostic approach should be based on the patient’s mode of presentations and prior clinical history, as well as on a systematic analysis of imaging patterns. This includes anatomical features, such as intra- vs. extra-axial, predominant gray matter or white matter involvement, supra-versus infratentorial, single vs. multiple, as well as signal characteristics on standard MR sequences, enhancement patterns, and findings on diffusion-weighted imaging, and hemorrhage-sensitive and perfusion sequences. Here we will discuss primary and secondary cerebral neoplasms in broad terms and illustrate the most important tumor mimics.