Contralateral recurrence of tumefactive demyelination

Khan, Mohammed Nazir; Guranda, Mihail; Essig, Marco

doi:10.1177/1971400915609798

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Acute treatment includes intravenous methylprednisolone and/or plasma exchange, rituximab and natalizumab, followed by immunomodulatory agents (16). Some patients have a monophasic selflimited course, but recurrence of the disease with new tumefactive lesions is not unusual (17). According to Lucchineti et al (9), the median time interval was 4.8 years until the second relapse.…”

Section: Discussionmentioning

confidence: 99%

Relapsing Tumefactive Demyelination: A Case Report

Omerhodžić

Džurlić

Lisica

et al. 2018

ama

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Objective. We present a case of relapsing tumefactive demyelination in a young female patient, that posed a real diagnostic challenge, with a heterogeneous clinical picture, atypical for multiple sclerosis (MS) presentation, and neuroradiological manifestations with a high suspicion of neoplastic diseases.Case Report. An 18-year old female patient presented to our Neurosurgical Out-patients’ Clinic with symptoms atypical for multiple sclerosis, unremarkable neurological deficit, one tumefactive lesion on MRI, followed by relapse and another two lesions within a period of six months. We decided to perform biopsy of the tumefactive lesion with compressive effect. Serological and clinical data were negative for MS, and the patient did not respond well to corticosteroid therapy. Fresh frozen tumor tissue aroused a strong suspicion of gemistocytic astrocytoma, so total resection was done, but the definitive pathohistological examination confirmed tumefactive demyelination.Conclusion. For clinicians, it is important to consider demyelinating disease in the differential diagnosis of a tumorlike lesion of the central nervous system, in order to avoid invasive and potentially harmful diagnostic procedures, especially in younger patients.

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Section: Discussionmentioning

confidence: 99%

Relapsing Tumefactive Demyelination: A Case Report

Omerhodžić

Džurlić

Lisica

et al. 2018

ama

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“…Tumefactive demyelinating lesions (TDLs) are a locally aggressive form of demyelination usually manifesting as a solitary lesion greater than 2 cm in size that may mimic a neoplasm on imaging studies 1,2 and may pose a diagnostic challenge in patients without a pre-existing diagnosis of multiple sclerosis. 3 These lesions more commonly occur in women with an average age of 37 years.…”

Section: Introductionmentioning

confidence: 99%

Demyelinating lesions behaving like aggressive tumours on advanced MRI techniques

et al. 2019

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Tumefactive demyelinating lesions are a rare disorder in which inflammatory demyelination manifests as solitary or multiple focal brain lesions (greater than 2 cm in size), which can be mistaken for glioma, lymphoma, metastasis and in some cases even brain abscess. The symptomatology of tumefactive demyelinating lesions depends on the white matter area involved and includes quickly progressing neurological deterioration of motor, sensory and visual function, praxis, language and mood impairment, as well as seizures. Recognising the key imaging features in a patient with a prior history of demyelination may expedite appropriate management. Preoperative diagnosis or at least the consideration of a demyelinating process is important to avoid unnecessary surgery. We report three patients with demyelinating lesions who presented with findings suggestive of demyelination on conventional magnetic resonance imaging studies. However, in all patients the lesions showed high perfusion and in two high permeability, which are findings generally seen with high-grade neoplasias. In rare instances, tumefactive demyelinating lesions may show increased perfusion and high permeability, imaging findings more commonly seen in high-grade gliomas. We suggest that if white matter lesions on conventional magnetic resonance imaging are compatible with tumefactive demyelinating lesions, atypical findings of high perfusion/permeability should not dissuade the radiologist from suggesting the presence of tumefactive demyelinating lesions rather than high-grade gliomas.

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