Coexistence of multiple sclerosis and brain tumours: Case report and review

Sirko, Andriy; Dzyak, Lyudmila; Chekha, E. V.; Малышева, Т. А.; Romanukha, Dmytro

doi:10.1016/j.inat.2019.100585

Cited by 6 publications

(6 citation statements)

References 17 publications

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“…People with MS seem to have an increased risk for brain tumors, 11 but it is unclear if this is related to the increased level of glial cell reactivity in MS, to immunosuppressive therapy, or increased detection with increased neuroimaging. 12 Mandel et al also report one case with ganglioglioma and MS, without epilepsy, who underwent surgery with unknown outcome. 13 Hofer et al report six patients with high-grade brain tumors without clinical MS deterioration after surgery, radiation, and chemotherapy, but MRI findings are not reported.…”

Section: Discussionmentioning

confidence: 99%

“…Our first patient had a ganglioglioma that caused the seizures. People with MS seem to have an increased risk for brain tumors, 11 but it is unclear if this is related to the increased level of glial cell reactivity in MS, to immunosuppressive therapy, or increased detection with increased neuroimaging 12 . Mandel et al also report one case with ganglioglioma and MS, without epilepsy, who underwent surgery with unknown outcome 13 .…”

Section: Discussionmentioning

confidence: 99%

“…Hofer et al report six patients with high‐grade brain tumors without clinical MS deterioration after surgery, radiation, and chemotherapy, but MRI findings are not reported 14 . Sirko et al report a high‐grade tumor case without clinical and radiological MS deterioration after surgery 12 . The potential relapse of MS in case of high‐grade brain tumors might be less important in the decision to perform brain surgery compared to low‐grade tumors or epilepsy surgery.…”

Section: Discussionmentioning

confidence: 99%

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Successful epilepsy surgery in two cases with multiple sclerosis

van Klink,

Tousseyn,

Schijns

et al. 2023

Epileptic Disorders

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Brain surgery is the only curative treatment for people with focal epilepsy, but it is unclear whether this induces active disease in multiple sclerosis (MS). This creates a barrier to evaluate MS patients for epilepsy surgery. We present two cases of successful epilepsy surgery in patients with pharmacoresistant epilepsy and stable MS, and give an overview of the existing literature. 1) a 28 year old woman with seizures arising from a right basal temporo‐occipital ganglioglioma was seizure free after surgery, without MS relapse but with one new MS lesion postsurgically. 2) a 46 year old woman with seizures arising from a natalizumab‐associated progressive multifocal leukoencephalopathy (PML) lesion in the right frontal lobe was seizure free after surgery preceded by extra‐operative subdural electrocorticography, with new subclinical MS lesions. We are the first to report brain surgery in a PML survivor. Both patients stabilized radiologically after initiating second line therapies. Successful epilepsy surgery can substantially increase the quality of life in patients with pharmacoresistant epilepsy and MS. With increasing survival rates of brain tumors and PML, the risk‐benefit ratio of epilepsy surgery compared to a potential MS relapse after surgery becomes critically important. Shared decision making is valuable for balancing the risks related to both diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Successful epilepsy surgery in two cases with multiple sclerosis

van Klink,

Tousseyn,

Schijns

et al. 2023

Epileptic Disorders

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“…In our analysis, the CNS tumours have the highest RR, but there are a lot of studies that did not report a significant difference between the general population and the population with MS in relation to the incidence of brain cancer 20,27,28 . There are over 100 subtypes and 29 histological variants, 70% being represented by gliomas 29 . Glioblastomas (61.5 %) and astrocytomas (18.8%) are the most frequent types of gliomas described in association with MS 30,31 .…”

Section: Discussionmentioning

confidence: 99%

"Are Multiple Sclerosis Patients Protected Against Some Types of Cancer?"

VASILE¹,

DUMITRU²,

CALOIANU³

et al. 2022

Arch Balk Med Union

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Est-ce que les patients avec de la sclérose en plaques sont-ils protégés contre certains types de cancer ?Introduction. Les facteurs de risque de la sclérose en plaques (SEP) et du cancer s'entrecroisent dans une large mesure. L'objectif de notre étude était d'estimer la prévalence et le RR des cancers chez les patients atteints de sclérose en plaques (SEP) et de découvrir lesquels types de cancer ont la plus faible fréquence. Matériel et méthodes. Nous avons effectué une recherche de la littérature dans les bases de données PubMed, Medline et Google Academic dans le but d'identifier des études d'envergure abordant le lien entre différents cancers et la SEP. À partir de 411 articles pertinents, nous avons sélectionné 13 travaux à analyser plus en détail, comprenant 109276 patients diagnostiqués avec SEP de différents pays.

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“…Another large study investigated the occurrence of brain tumors in 33 different autoimmune diseases and found that none of them (including MS) influences the risk of glioma development but that autoimmune diseases negatively affect survival in glioma and meningioma patients, probably due to the added physical burden or therapeutic limitations [3]. Accordingly, some of the challenges the clinical management of concurrent CNS tumors and MS pose have been described in the literature but due to the rare coincidence of these two CNS diseases, current evidence is limited to single case reports and, to our best knowledge, no cohort studies have been reported [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Concurrent CNS tumors and multiple sclerosis: retrospective single-center cohort study and lessons for the clinical management

et al. 2022

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Introduction The concurrent presence of both central nervous system (CNS) tumors and multiple sclerosis (MS) poses various diagnostic and therapeutic pitfalls and makes the clinical management of such patients challenging. Methods In this retrospective, single-center cohort study, we searched our clinical databases (2006–2019) for patients with concurrent CNS tumors and MS and described their disease courses. Age at diagnosis of the respective disease and probabilities for MS disease activity events (DAEs) with vs. without prior tumor-specific therapy were tested pairwise using t-test for dependent samples and exact binomial test. Results N = 16 patients with concurrent CNS tumors and MS were identified. MS diagnosis preceded the CNS oncological diagnosis by an average of 9 years (p = 0.004). More DAEs occurred in patients without prior chemotherapy (83.3%) than in patients with prior chemotherapy (16.7%; p = 0.008). This effect did not reach significance for patients with prior radiation therapy/radiosurgery (66.7% vs. 33.3%, p = 0.238). The average interval between DAEs and the last documented lymphopenia was 32.25 weeks. Conclusions This study describes the clinical and demographic features of patients with concurrent CNS tumors and MS and suggests several practical approaches to their clinical management. Our findings suggest that adding a disease-modifying MS therapy to the regimen of patients treated with chemotherapy is necessary only if the patient suffers from a highly active, aggressive course of MS. In view of the lack of prospective trials, individual risk assessments should remain the foundation of the decision on MS treatment in concurrent CNS tumor diseases.

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Coexistence of multiple sclerosis and brain tumours: Case report and review

Cited by 6 publications

References 17 publications

Successful epilepsy surgery in two cases with multiple sclerosis

Successful epilepsy surgery in two cases with multiple sclerosis

"Are Multiple Sclerosis Patients Protected Against Some Types of Cancer?"

Concurrent CNS tumors and multiple sclerosis: retrospective single-center cohort study and lessons for the clinical management

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