A Diagnostic Dilemma: A Case Report of Tumefactive Multiple Sclerosis

10.6966/EDMJ.202209_9(3).0005

Pao-Li Hsiao；Hung-Chang Kuo

tumefactive ； multiple sclerosis ； tumor-like ； inflammatory

E-Da Medical Journal

9卷3期（2022 / 09 / 01）

36 - 39

英文

We present a case of central nervous system inflammatory lesion presented with tumor-like radiographic feature. Under the diagnosis of tumefactive multiple sclerosis, the patient received steroid therapy with evident clinical improvement alongside image confirmation for lesion regression. The case report seeks to highlight such diagnostic dilemma with a possibility of misdiagnosis for brain tumor. The physician therefore must integrate clinical picture with laboratory investigations and imaging techniques to avoid unnecessary surgical procedures.

1. Kuan YC, Wang KC, Yuan WH, et al: Tumefactive multiple sclerosis in Taiwan. PLoS One 2013;8:e69919. doi: 10.1371/journal.pone.0069919.
   連結：
2. Lucchinetti CF, Gavrilova RH, Metz I, et al: Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis. Brain 2008;131:1759-75. doi: 10.1093/brain/awn098.
   連結：
3. Hu W, Lucchinetti CF: The pathological spectrum of CNS inflammatory demyelinating diseases. Seminars in Immunopathology 2009;31:439-53. doi: 10.1007/s00281-009-0178-z.
   連結：
4. Abou Zeid N, Pirko I, Erickson B, et al: Diffusion-weighted imaging characteristics of biopsy-proven demyelinating brain lesions. Neurology 2012;78:1655-62. doi: 10.1212/WNL.0b013e3182574f66.
   連結：
5. Wong TZ, van der Westhuizen GJ, Coleman RE: Positron emission tomography imaging of brain tumors. Neuroimaging Clinics of North America 2002;12:615-26. doi: 10.1016/s1052-5149(02)00033-3.
   連結：
6. Hardy TA, Chataway J: Tumefactive demyelination: an approach to diagnosis and management. J Neurol Neurosurg Psychiatry 2013;84:1047-53. doi: 10.1136/jnnp-2012-304498.
   連結：
7. Ramanathan S, Prelog K, Barnes EH, et al: Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis. Multiple Sclerosis Journal 2015;22:470-82. doi:10.1177/1352458515593406.
   連結：
8. Siri A, Carra-Dalliere C, Ayrignac X, et al: Isolated tumefactive demyelinating lesions: diagnosis and long-term evolution of 16 patients in a multicentric study. J Neurol 2015;262:1637-45. doi: 10.1007/s00415-015-7758-8.
   連結：
9. Hayashi T, Kumabe T, Jokura H, et al: Inflammatory demyelinating disease mimicking malignant glioma. J Nucl Med 2003;44:565-9.