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Management of Recurrent Tumefactive Multiple Sclerosis: Case Report and Literature Review

Jamir Pitton Rissardo1, Ana Letícia Fornari Caprara1

  • 1Department of Neurology, Federal University of Santa Maria, Santa Maria, RS, Brazil.

Asian Journal of Neurosurgery
|October 5, 2018
PubMed

Insights

Tumefactive multiple sclerosis, a rare MS form, can mimic brain tumors. This case highlights a patient with tumefactive MS who developed new lesions years after initial treatment, emphasizing the need for long-term monitoring.

Area of Science:

  • Neurology
  • Neuro-oncology
  • Neuroimmunology

Background:

  • Tumefactive multiple sclerosis (MS) presents as a solitary, large demyelinating lesion, often mimicking brain tumors.
  • Intracranial hypertension requiring decompressive craniectomy (DC) in tumefactive MS is rare, with limited follow-up data on lesion evolution.

Observation:

  • A 28-year-old female presented with acute hemiparesis, headache, and nausea, progressing to coma and uncal herniation.
  • Initial brain MRI showed a large left parietal lobe lesion; DC and resection confirmed active demyelinating disease.

Findings:

  • The patient experienced a recurrence 11 years later with new neurological deficits and a newly identified lesion on CT scan.
  • Despite the recurrence, the patient recovered and showed no new lesions on MRI after three months.

Implications:

  • This case underscores the potential for late-onset new lesions in tumefactive MS, even after significant recovery.
  • Long-term neuroimaging surveillance is crucial for patients with tumefactive MS to detect evolving disease patterns.
Keywords:
Decompressive craniectomypseudotumoral multiple sclerosistumefactive multiple sclerosis

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