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Glioma and multiple sclerosis: case report
Lineu Cesar Werneck1, Rosana Herminia Scola, Walter Oleschko Arruda
1Internal Medicine Department, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil. werneck@hc.ufpr.br
Abstract:
We report a case of a 44-years-old woman with relapsing-remitting and secondarily progressive form of multiple sclerosis (MS) since aged 24 years, who developed an anaplastic astrocytoma. The neurological manifestations of the tumor were misinterpreted as resulting from MS. Sequential MRI examination and seizures raised the possibility of another nature of her symptoms, besides MS. Her initial good response to high doses corticosteroids led to the initial assumption her symptoms were only exclusively due to the demyelinating process. She underwent craniotomy with radical excision of the lesion. Pathological examination disclosed anaplastic astrocytoma. Other cases of coincidental MS and primary CNS tumors are reviewed, as well as their possible relation.
Insights
A patient with multiple sclerosis (MS) developed an anaplastic astrocytoma, with symptoms initially misdiagnosed as MS progression. Early detection through MRI and seizure observation was crucial for accurate diagnosis and treatment of the brain tumor.
Area of Science:
- Neuroscience
- Oncology
- Neurology
Background:
- Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Co-occurrence of MS and primary central nervous system (CNS) tumors is rare but documented.
- Neurological symptoms in MS can overlap with those of CNS tumors, complicating diagnosis.
Observation:
- A 44-year-old woman with a long history of MS presented with neurological symptoms.
- Initial symptoms were attributed to MS exacerbation, supported by a positive response to corticosteroids.
- Subsequent MRI scans and the onset of seizures prompted further investigation.
Findings:
- The patient was diagnosed with an anaplastic astrocytoma, a type of malignant brain tumor.
- Surgical excision of the tumor was performed.
- Pathological examination confirmed the anaplastic astrocytoma diagnosis.
Implications:
- This case highlights the diagnostic challenges when MS and CNS tumors coincide.
- Highlights the importance of considering alternative diagnoses in MS patients with atypical or worsening symptoms.
- Emphasizes the need for thorough diagnostic workups, including advanced imaging and seizure evaluation, in complex neurological cases.