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Ring-enhanced Mass in the Brain of a Woman With Systemic Lupus Erythematosus and Elevated Serum CA19-9 Level: Brain Abscess or Metastatic Tumor? Case Report

Joji INAMASU, Yoshiki NAKAMURA, Ryoichi SAITO, Yoshiaki KUROSHIMA, Keita MAYANAGI, Shigeo OHBA, Masahiko NISHIKAI, Kazunori KOYAMA, Kiyoshi ICHIKIZAKI
2003 Neurologia medico-chirurgica  
A 70-year-old woman with systemic lupus erythematosus presented with a brain abscess manifesting as progressive monoparesis of the right lower extremity over 4 days. She had had no episodes of fever, and did not complain of headache or exhibit any signs of meningeal irritability. Computed tomography of the brain showed a round, low-density mass with strong ring enhancement in the left frontal lobe. Laboratory examination found a moderately elevated serum level of CA19-9, a marker of some
more » ... rker of some digestive organ cancers. Together with the absence of febrile episodes, headache, and a rise in leukocyte count, the initial suspicion was metastatic brain tumor rather than brain abscess. However, diffusion-weighted magnetic resonance imaging depicted the mass as a very hyperintense area. The neuroimaging diagnosis was brain abscess. After conservative treatment with intravenous antibiotics for 6 weeks, the brain abscess completely resolved, and the patient was discharged without neurological deficits.
doi:10.2176/nmc.43.43 pmid:12568322 fatcat:44bwyiz2zzgkvd33pe5kmgvlwy