Unusual Cerebral Involvement of Rheumatoid Arthritis Mimicking a Tumor

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Author(s): Sevil Tokdemir* , Huseyin Toprak , Alpay Alkan .

Journal Name: Current Medical Imaging

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Background: The central nervous system’s involvement in Rheumatoid Arthritis (RA) is infrequent and can be life-threatening. Mass-like CNS involvement is an unusual presentation. A 45 year old man had suffered seropositive rheumatoid arthritis for five years referred to our hospital with one-week history of right-sided facial paralysis, left hemiparesis and headache. Discussion: MRI demonstrated hyperintense mass-like lesion extended from mesencephalon to right hippocampus and basal ganglia on T2 and FLAIR images. On DWI, restricted diffusion was not present. After contrast administration; minimal contrast enhancement was noted. After methotrexate and steroid treatment, the size had been markedly shrunken on the follow-up images. The clinical symptoms were also improved. Conclusion: To our knowledge, the mass-like presentation was not reported in the literature. We report an unusual case of brain involvement of rheumatoid arthritis mimicked tumor.

Keywords: Rheumatoid arthritis, Inflammatory pseudotumor, magnetic resonance imaging, cerebral , brain

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(E-pub Ahead of Print)
DOI: 10.2174/1573405614666180911121222
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