Tumefactive Multiple Sclerosis of the Cervical Spinal Cord: A Rare Case Report

Mamilly, Ahmed; Aslan, Asala; Adeeb, Nimer; Asfari, Aya Al; Cuéllar, Hugo

doi:10.7759/cureus.6754

Cited by 4 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TMS is an uncommon variant of MS characterized by tumefactive demyelinating lesions (TDLs) larger than 2 cm and may be associated with mass effect and/or edema; it is often cannot be differentiated from CNS neoplasms, especially glioma and CNS lymphoma [ 3 , 6 ]. TMS is estimated to affect 1-3/1,000 MS cases, with an annual incidence of 0.3/100,000 people [ 8 ]. TDLs are not an uncommon manifestation of demyelinating disease, with an incidence of 2.8% of MS cases.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Challenges and Radiological Spectrum of Tumefactive Multiple Sclerosis: A Case Report Study

Muddassir¹,

Badirah²,

Alshahrani³

et al. 2022

Cureus

View full text Add to dashboard Cite

Multiple sclerosis (MS) is a chronic disease of the central nervous system (CNS). It has many types, which include tumefactive multiple sclerosis (TMS), one of the most uncommon types. We present the case of a 36year-old woman who presented with right-sided numbness of the body. Magnetic resonance imaging (MRI) of the brain revealed a large mass (3 cm × 2.5 cm) in the deep white matter of the right frontal lobe along with smaller lesions of variable sizes. After considering the MRI features, the CSF results, and the improvement of the symptoms with a high dose of steroids, the diagnosis of tumefactive multiple sclerosis was made. A biopsy was not done on our patient as the symptoms resolved after treatment, although sometimes it is necessary for diagnosing tumefactive multiple sclerosis to rule out tumors or abscesses. The current study described the clinical presentation, the role of imaging, the differential diagnosis, and the treatment options. This case report aimed to report a rare presentation of TMS, which highlights the importance of differentiating TMS from other space-occupying lesions for prompt and proper management.

show abstract

Section: Discussionmentioning

confidence: 99%

Diagnostic Challenges and Radiological Spectrum of Tumefactive Multiple Sclerosis: A Case Report Study

Muddassir¹,

Badirah²,

Alshahrani³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Furthermore, relative to brain abscesses and tumors the mass effect along with edema in TMS are proportionally smaller relative to plaque size. It has been suggested that the lack of mass effect differentiates MS plaques from other space-occupying lesions (11,22,23).…”

Section: Imagingmentioning

confidence: 99%

“…Most TDL demonstrate increased DWI and ADC signals on MRI, allowing differentiation of lymphomas with a water diffusivity restriction that makes them hyperintense on DWI and hypointense on ADC maps. Occasionally, acute demyelinating lesions may have areas of diffusion restriction with reduced ADC values at the periphery of the lesion (6,23,25).…”

Section: Imagingmentioning

confidence: 99%

Tumefactive multiple sclerosis

Ortega-Sierra¹,

Delgado-Marrugo²,

Campo-Bedoya³

et al. 2021

roneuro

View full text Add to dashboard Cite

Tumefactive multiple sclerosis is a rare variant of multiple sclerosis, characterized by the presence of brain lesions that may be solitary or multiple. Considering that these lesions have a pseudotumoral appearance, it is a challenge to differentiate them from central nervous system neoplasms through neuroimaging. Many cases are associated with the administration of monoclonal antibodies, and due to an increase in the incidence of cancer globally, it is expected that secondary to chemotherapeutic treatments, more and more cases may appear. Taking into account the above, the objective of this review is to review aspects of usefulness in clinical practice, on the diagnosis and approach of this pathological condition

show abstract