Abstract
Background
Multiple sclerosis (MS) with initial neuroradiological features suggestive of brain
tumour (tumour-like MS) may represent a challenging diagnosis.
Methods
Among the patients seen at the MS centre of our Institution between 2000 and 2010,
we identified cases presenting with a large (diameter>2 cm), well-defined lesion, suggestive of brain tumour on initial brain magnetic resonance
imaging (MRI). Only patients with at least 10 years follow-up were included.
Results
Five young women with MS who presented with a tumour-like lesion on initial brain
MRI are described. All cases presented with sudden-onset neurological deficits due
to a single large brain lesion compatible with neoplasm at MRI. Two cases underwent
brain stereotactic biopsy, both misdiagnosed as astrocytoma. However, the subsequent
clinical and MRI follow-up was consistent with MS in all cases. Unnecessary surgery
and radiotherapy were responsible for disability in two cases. In three cases, the
course of the disease remains benign after more than 13 years from symptoms onset.
Conclusions
Our report of clinical, radiological and pathological features of five tumour-like
MS cases confirms that it is mandatory to consider a demyelinating process in the
differential diagnosis of tumour-like brain lesions. Many tumour-like MS cases may
have a favourable long term prognosis.
Keywords
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Article info
Publication history
Published online: November 13, 2012
Accepted:
October 24,
2012
Received in revised form:
October 21,
2012
Received:
August 22,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
