Prognostic factors in Tumefactive demyelinating lesions: A retrospective study

Area of Science:

• Neurology
• Radiology
• Pathology

Background:

• Demyelinating lesions can appear as mass-like lesions on imaging, mimicking malignancy.
• The clinical course of tumefactive demyelinating lesions (TDLs) requires further definition.

Purpose of the Study:

• To identify predictors of aggressive disease course in patients with tumefactive demyelinating lesions.

Main Methods:

• Retrospective analysis of 21 patients with biopsy-proven demyelination presenting with mass-like brain lesions.
• Median follow-up of 52 months for 18 patients.
• Correlation of clinical, radiologic, and histologic features with disease course.

Main Results:

• 33% of patients exhibited an aggressive disease course (ADC).
• ADC was associated with initial largest lesion size ≥35 mm, mass effect, and perilesional edema on MRI.
• Presentation at age 30 years or older and absence of prior tonsillectomy were also linked to ADC.

Conclusions:

• Initial lesion size, mass effect, perilesional edema, age at presentation, and prior tonsillectomy status predict aggressive disease course in TDLs.
• These predictors can aid in patient follow-up and intervention stratification.