Clinical Profile, Radiologic Features, and Clinical Course of Tumefactive Demyelinating Lesions in Two Tertiary...

Tumefactive demyelinating lesions (TDLs) are demyelinating lesions that can mimic tumors on imaging by presenting with mass effect, edema, and ring enhancement. They may be associated with a central demyelinating disease such as multiple sclerosis, neuromyelitis optica, or myelin oligodendrocyte glycoprotein antibody-associated disease. We aimed to determine the clinical, laboratory, and radiologic features, as well as the prognosis, of eight adult patients with TDLs at two tertiary hospitals in the Philippines. We conducted a chart review of patients diagnosed with TDLs from January 2014 to July 2024. Eight patients were diagnosed with TDLs. Most were treated as cases of multiple sclerosis. One tested positive for anti-aquaporin 4 antibody, and another was treated as a case of acute disseminated encephalomyelitis. All patients were given methylprednisolone pulse therapy. The majority of patients had a monophasic course, with symptoms resolving at follow-up. Among Filipino patients, TDLs are rarely diagnosed but mostly have a favorable prognosis.