Pseudomass-like CNS Lesions in Neuro-Behçet’s Syndrome: A Narrative Review of a Rare Radiological Entity and Its Diagnostic Challenges

Abstract

Neuro-Behçet’s syndrome (NBS) is an uncommon but potentially disabling manifestation of Behçet’s disease. While typical parenchymal NBS predominantly affects the brainstem, basal ganglia, and diencephalon, a rare subset presents as tumefactive or pseudomass-like lesions that mimic neoplasm, infection, and demyelinating disorders. These lesions create substantial diagnostic uncertainty and may lead to unnecessary neurosurgical intervention if misinterpreted. This narrative review synthesizes published evidence on pseudomass-like NBS, focusing on clinical context, neuroimaging patterns, pathological correlates, differential diagnosis, and treatment response to immunosuppressive therapy. A representative clinical vignette is included to illustrate typical radiological evolution and regression after therapy. Improved awareness of this rare radiological entity may facilitate timely diagnosis, avoid invasive procedures, and improve outcomes.