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Updated: Mar 16, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Is size an essential criterion to define tumefactive plaque? MR features and clinical correlation in multiple
Lucia Patriarca1, Silvia Torlone1, Fabiana Ferrari1
1Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy.
Abstract:
Tumefactive multiple sclerosis is an inflammatory demyelinating disease of the central nervous system. It has recently been described as a rare subtype of multiple sclerosis (MS) characterised by the appearance of solitary or multiple space-occupying lesions associated with imaging characteristics mimicking neoplasm. Atypical features include plaque size >2 cm with mass effect, oedema, and/or ring enhancement on magnetic resonance (MR) images.This study is a retrospective review designed to evaluate the prevalence of tumefactive plaques in a selected population of 440 MS patients referred to our MS centre in Southern Italy between 2005 and 2014. We analysed the radiographic features of lesions ranging in size from 0.5 to 2 cm to establish whether smaller plaques with MR characteristics similar to tumefactive plaques present different symptoms, disease evolution and prognosis. We also aimed to ascertain if MR features suggestive of biological aggressiveness could be useful prognostic criteria for a correct diagnosis of the disease and subsequent treatment. Our data suggest that lesions 0.5-2 cm and >2 cm have similar MR features and clinical evolution.
Insights
Tumefactive multiple sclerosis, a rare MS subtype, presents with large lesions mimicking tumors. Smaller lesions (<2cm) share similar imaging features and clinical outcomes with larger tumefactive plaques.
Area of Science:
- Neurology
- Neuroimmunology
- Radiology
Background:
- Tumefactive multiple sclerosis (MS) is a rare inflammatory demyelinating disease.
- It is characterized by large, space-occupying lesions that can mimic neoplasms on imaging.
- Atypical features include large plaque size (>2cm) with mass effect, edema, and ring enhancement on MRI.
Purpose of the Study:
- To evaluate the prevalence of tumefactive plaques in a cohort of MS patients.
- To analyze smaller lesions (0.5-2cm) with tumefactive characteristics.
- To determine if lesion size impacts symptoms, disease progression, and prognosis.
Main Methods:
- Retrospective review of 440 MS patients diagnosed between 2005 and 2014.
- Analysis of radiographic features of lesions, focusing on size and MRI characteristics.
- Comparison of clinical evolution and prognosis between smaller and larger lesions.
Main Results:
- Lesions measuring 0.5-2cm exhibited similar MRI features to larger tumefactive plaques (>2cm).
- Clinical evolution and prognosis were comparable between smaller and larger lesions.
- The study suggests that lesion size alone may not be the sole determinant of disease behavior.
Conclusions:
- Smaller lesions with tumefactive imaging characteristics appear to follow a similar clinical course to larger tumefactive plaques.
- MRI features suggestive of aggressiveness may be present in lesions of varying sizes.
- Further research is needed to refine prognostic criteria for tumefactive MS.
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