Glioma and multiple sclerosis: case report

Abstract

-We report a case of a 44-years-old woman with relapsing-remitting and secondarily progressive form of multiple sclerosis (MS) since aged 24 years, who developed an anaplastic astrocytoma. The neurological manifestations of the tumor were misinterpreted as resulting from MS. Sequential MRI examination and seizures raised the possibility of another nature of her symptoms, besides MS. Her initial good response to high doses corticosteroids led to the initial assumption her symptoms were only exclusively due to the demyelinating process. She underwent craniotomy with radical excision of the lesion. Pathological examination disclosed anaplastic astrocytoma. Other cases of coincidental MS and primary CNS tumors are reviewed, as well as their possible relation.KEY WORDS: multiple sclerosis, anaplastic astrocytoma, cerebral neoplasm.Glioma e esclerose múltipla: relato de caso Glioma e esclerose múltipla: relato de caso Glioma e esclerose múltipla: relato de caso Glioma e esclerose múltipla: relato de caso Glioma e esclerose múltipla: relato de caso RESUMO -Relatamos o caso de uma paciente de 44 anos, portadora de esclerose múltipla forma surtoremissão e progressiva secundária, que na evolução desenvolveu um astrocitoma anaplásico. Os sintomas do tumor se confundiram com os da esclerose múltipla e com a repetição de ressonâncias magnéticas foi possível suspeitar do diagnóstico. Além dos sinais neurológicos, também apresentava crises convulsivas. A melhora com os cursos de pulsoterapia mascaravam os sintomas do tumor. Submetida a craniotomia e retirado tumor com características histológicas e histoquímicas de astrocitoma anaplásico, ao lado de áreas de desmielinização típicas de esclerose múltipla. São discutidos os aspectos radiológicos, incidência e mecanismos da concomitância das duas doenças. PALAVRAS-CHAVE: esclerose múltipla, astrocitoma anaplásico, tumor cerebral.

Demyelinating disease simulating brain tumours: A histopathologic assessment of seven cases

“…The concurrent rare occurrence of demyelinating disease with gliomatous and non-gliomatous neoplasms complicates the picture. [17,18,19] Though the neoplastic transformation of reactive glial cells in multiple scleroses plaques has been proposed as the source of gliomas, such association appear to be more coincidental. Gliomas reported in association with multiple sclerosis are more frequently (30%) multicentric than are uncomplicated gliomas.…”

Demyelinating diseases

“…Rarely, glial tumours have arisen within lesions of multiple sclerosis. [54][55][56][57] Make best use of the tissue If warned about the possibility of demyelination, be sure to freeze some of the fresh tissue and, ideally, also fix some for possible electron microscopy. Once it has been established that the biopsy shows demyelination rather than tumour or some other disease, the frozen tissue can be used to look for viral DNA or RNA.…”

Multicentric Glioblastoma Mimicking Demyelinating Plaque Disease

“…11 That hypothesis was also supporting the multicentricity of gliomas accompanying multiple sclerosis. 11,13 Our patient with clinical and radiologic findings strongly suggestive of demyelinating plaque disease was shown by the excisional biopsy to have glioblastoma. Such patients emphasize the importance of considering the multicentric gliomas in the differential diagnosis of demyelinating lesions before establishing the therapeutic strategy even in case of a previous cancer history.…”