title: Primary angiitis of the central nervous system presenting as a mass lesion.
abstract: We report a 51-year-old Asian man with primary angiitis of the central nervous system (PACNS) with atypical presentation as a mass lesion. PACNS is an uncommon condition causing inflammation and destruction of the blood vessels of the central nervous system. The aetiology is unclear and multiple mechanisms have been proposed. Its incidence is estimated at 2.4 per million per year, affecting patients of all ages (median 50 years) and more commonly Caucasian men. In Australia, 12 patients fulfilled the diagnostic criteria for PACNS between 1998 and 2009 at The Royal Melbourne Hospital, a university-affiliated tertiary referral centre. The accurate and timely diagnosis of PACNS is very challenging due to disease mimicry and the absence of specific serological tests. This patient illustrates additional diagnostic difficulty with his atypical PACNS presentation as a mass lesion.
authors.affiliation: Department of Neurology, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia. Electronic address: calvin.gan@mh.org.au.
authors.forename: Calvin
authors.initials: C
authors.lastname: Gan
authors.affiliation: Department of Neurology, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia.
authors.forename: Julian
authors.initials: J
authors.lastname: Maingard
authors.affiliation: Department of Neurology, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Giles
authors.affiliation: Department of Radiology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia.
authors.forename: Pramit M
authors.initials: PM
authors.lastname: Phal
authors.affiliation: Department of Neurology, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia.
authors.forename: K Meng
authors.initials: KM
authors.lastname: Tan
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D020293:Vasculitis, Central Nervous System / Q000473:pathology*
keywords: Basal ganglia; Magnetic resonance imaging (MRI); Mass lesion; Primary angiitis of the central nervous system (PACNS); Tumour-like lesion; Vasculitis