[Giant lesions in multiple sclerosis--a diagnostic challenge].

Area of Science:

• Neurology
• Neuroimmunology
• Neurobiology

Background:

• Multiple sclerosis is a common demyelinating disease of the central nervous system in young adults.
• It disrupts signal transduction due to myelin sheath destruction.
• The disease typically presents with relapsing-remitting or steady neurological decline.

Observation:

• Diagnosis relies on clinical history, neurological exams, evoked potentials, CSF analysis (oligoclonal bands), and MRI.
• Multiple sclerosis can exceptionally manifest as a mass lesion, clinically and radiologically resembling a brain tumor.
• Two cases of giant tumefactive lesions were identified.

Findings:

• Brain biopsy confirmed the tumefactive lesions were of demyelinating nature.
• These large lesions mimicked brain tumors in presentation.
• The findings highlight a rare presentation of multiple sclerosis.

Implications:

• Recognizing tumefactive demyelinating lesions is crucial for accurate diagnosis and treatment.
• This presentation underscores the importance of considering demyelinating diseases in the differential diagnosis of brain tumors.
• Further research into atypical presentations of multiple sclerosis is warranted.