Tumefactive multiple sclerosis (MS) is a rare form of demyelinating disease. The natural course of the disease has been characterized as presenting with a mass-like demyelinating lesion converting to typical relapsing-remitting disease with future exacerbations. Herein we describe a case of a patient whom over a six-year period developed relapsing-remitting tumefactive MS. The natural course, pathophysiology, prognosis and diagnosis are briefly discussed.
Kepes J.Large focal tumor-like demyelinating lesions of the brain: intermediate entity between multiple sclerosis and acute disseminated encephalomyelitis?Ann Neurol1993; 33: 18-27 .
2.
Gutrecht JA , Berger JR , Jones RH , Mancall AC.Mono-focal acute inflammatory Demyelination (MAID): a unique disorder simulating brain neoplasm . South Med J2000; 95: 1180-1186 .
Bakshi R , Glass J , Louis DN , Hochberg FH.Magnetic resonance imaging features of solitary inflammatory brain masses . J Neuroimaging1998; 8: 8-14 .
5.
Ernst T , Chang L , Walot I , Huff K.Physiologic MRI of a tumefactive multiple sclerosis lesion . Neurology1998; 51: 1486-1488 .
6.
Law M , Meltzer DE , Cha S.Spectroscopic magnetic resonance imaging of a tumefactive demyelinating lesion . Neuroradiology2002; 44: 986-989 .
7.
Butteriss DJ , Ismail A , Ellison DW , Birchall D.Use of serial proton magnetic resonance spectroscopy to differentiate low grade glioma from tumefactive plaque in a patient with multiple sclerosis . Br J Radiol2003; 76: 662-665 .
8.
Sugita Y , Terasaki M , Shigemori M , Sakata K , Morimatsu M.Acute focal demyelinating disease simulating brain tumors: histopathologic guidelines for an accurate diagnosis . Neuro-pathology2001; 21: 25-31 .
9.
Zagzag D , Miller DC , Kleinman GM , Abati A , Donnenfeld H , Budzilovich GN.Demyelinating disease versus tumor in surgical neuropathology. Clues to a correct pathological diagnosis . Am J Surg Pathol1993; 17: 537-545 .
10.
Rosenfeld SS , Hoffman JM , Coleman RE , Glantz MJ , Hanson MW , Schold SC.Studies of primary central nervous system lymphoma with fluorine-18-fluorodeoxyglucose positron emission tomography . J Nucl Med1992; 33: 532-536 .
11.
Villringer K , Jager H , Dichgans M , Ziegler S , Poppinger J , Herz Met al.Differential diagnosis of CNS lesions in AIDS patients by FDG-PET . J Comput Assist Tomogr1995; 19: 532-536 .
12.
Olivero WC , Dulebohn SC , Lister JR.The use of PET in evaluating patients with primary brain tumours: is it useful?J Neurol Neurosurg Psychiatry1995; 58: 250-252 .
