Tumefactive multiple sclerosis masquerade as a central nervous system tumor: a case report

Area of Science:

• Neurology
• Neuroimmunology
• Radiology

Background:

• Tumefactive multiple sclerosis (MS) presents as a rare, tumor-like demyelinating lesion.
• Accurate diagnosis is challenging, often requiring biopsy to differentiate from brain tumors.

Observation:

• A 37-year-old woman with a family history of cancer was initially misdiagnosed with CNS glioma.
• She presented with headache and atypical MRI findings.
• Improvement with intravenous steroids suggested a demyelinating process.

Findings:

• Cerebrospinal fluid (CSF) analysis and MRI features were crucial in diagnosing tumefactive MS.
• The patient's refusal of biopsy underscored the need for non-invasive diagnostic approaches.
• Initiation of disease-modifying treatment (DMT) led to a stable clinical course.

Implications:

• This case emphasizes the importance of considering tumefactive MS in the differential diagnosis of brain tumors.
• Recognizing TDLs can help clinicians avoid unnecessary invasive procedures like biopsies.
• Early and accurate diagnosis facilitates timely initiation of appropriate treatment for tumefactive MS.