Concurrence of multiple sclerosis and primary intracranial neoplasms

The concurrence of multiple sclerosis and primary intracranial neoplasms is uncommon. The literature contains 20 cases of multiple sclerosis associated with gliomas and nine cases with non-gliomatous neoplasms. This report describes a protoplasmic astrocytoma and arteriovenous malformation found incidentally at autopsy of a 63-year-old woman with a 25-year history of multiple sclerosis. This is the first demonstrated association of multiple sclerosis with an arteriovenous malformation. Although neoplastic transformation of reactive glial cells in multiple sclerosis plaques has been proposed as the source of gliomas, the association of multiple sclerosis with astrocytoma and arteriovenous malformation in the present case is considered to be coincidental. Gliomas reported in association with multiple sclerosis are more frequently (30%) multicentric than are uncomplicated gliomas.