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Multiple sclerosis simulating a mass lesion.

D I Friedman1

  • 1Department of Neurology, SUNY Upstate Medical University, Syracuse, New York, USA.

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
|September 23, 2000
PubMed
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Multiple sclerosis can rarely mimic brain tumors. Two young women presented with vision loss and enlarging brain lesions, but biopsy revealed demyelination, not cancer.

Area of Science:

  • Neuroscience
  • Neurology
  • Ophthalmology

Background:

  • Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
  • MS typically presents with varied neurological symptoms due to demyelination.
  • Atypical presentations of MS can pose diagnostic challenges.

Observation:

  • Two young women presented with homonymous hemianopia, a visual field defect.
  • Neuroimaging revealed progressively enlarging intracranial mass lesions in both patients.
  • One patient experienced neurological decline despite corticosteroid therapy.

Findings:

  • Stereotactic biopsy in both cases showed demyelination consistent with multiple sclerosis.
  • This indicates that large demyelinating plaques can present as mass lesions.

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  • The findings highlight the infrequent but possible presentation of MS as a space-occupying lesion.

    • Implications:

    • Atypical MS presentations can be misdiagnosed as brain tumors, infections, or other demyelinating conditions.
    • Neuroimaging and clinical findings must be carefully evaluated to avoid diagnostic errors in suspected MS cases.
    • Recognizing MS as a potential cause of mass lesions is crucial for timely and appropriate treatment.