Brain Abscesses Mimicking Malignancy

Abstract Given their clinical and radiological resemblance to brain metastases, brain abscesses frequently pose diagnostic challenges, complicating the differential diagnosis process. This study investigates 3 distinct cases where brain abscesses appeared to be metastatic brain tumors, demonstrating the critical need for clear differentiation between infectious and neoplastic brain lesions. In the first case, a 77-year-old female with follicular lymphoma developed a parietal lobe mass that was subsequently discovered to be caused by Nocardia , resulting in specialized antibiotic therapy. The second case involved a 64-year-old female with advanced squamous cell cancer who presented with a temporal lobe abscess caused by Streptococcus constellatus , which was treated with complex antibiotic protocols and neurosurgical surgery. Furthermore, a 58 - year-old female with follicular lymphoma exhibited brain lesions and latent infections, which were ultimately identified as Aspergillus species. These cases reflect the challenges in accurately diagnosing brain abscesses, highlighting the importance of a comprehensive diagnostic approach to distinguish between infectious and neoplastic brain lesions. Early detection and individualized treatment interventions are critical for optimal patient outcomes in such complicated clinical settings.