A tumefactive demyelinating lesion in a person with MS after five years of fingolimod

In this report, we discuss the occurrence of intracerebral hemorrhage in a patient with multiple sclerosis during treatment with natalizumab, a humanized monoclonal antibody against the α4β1-integrin. Hemorrhage was located in a previously tumefactive demyelinating lesion. The mechanisms of leukocyte recruitment to the sites of inflammation through interaction of leukocyte α4β1-integrins and endothelial vascular cell adhesion molecule-1 are well known. However, α4β1-integrins are also expressed on endothelial cells and CD34+ bone marrow–derived progenitor cells, controlling several key pathways in angiogenesis. Neovascularization may contribute to tissue repair, particularly in large inflammatory cerebral lesions with increased vascular fragility. We discuss possible interaction of natalizumab with angiogenesis during tissue repair.

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Multiple Sclerosis and Oligodendroglioma: An Exceptional Association

Case Reports in Neurological Medicine ◽

10.1155/2014/546817 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Ana Teresa Carvalho ◽

Paulo Linhares ◽

Lígia Castro ◽

Maria José Sá

Keyword(s):

Multiple Sclerosis ◽

Brain Tumor ◽

Male Patient ◽

Accurate Diagnosis ◽

Radiological Features ◽

Cerebral Mri ◽

Tumefactive Demyelinating Lesion ◽

Extensive Lesion ◽

Cerebral Biopsy

The cooccurrence of multiple sclerosis (MS) and oligodendroglioma is very rare. We present a 43-year-old male patient with the diagnosis of MS lasting for 14 years who developed seizures and right hemiparesis; cerebral MRI revealed an already known extensive lesion, previously misdiagnosed as tumefactive demyelinating lesion. Cerebral biopsy leads to oligodendroglioma diagnosis, successfully treated with radiotherapy. The diagnosis of a brain tumor in a MS patient is challenging. The atypical clinical and radiological features are the key for accurate diagnosis. In such cases, a brain tumor has to be kept in mind no matter how rare this association is.

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Spectroscopic magnetic resonance imaging of a tumefactive demyelinating lesion

Neuroradiology ◽

10.1007/s00234-002-0872-1 ◽

2002 ◽

Vol 44 (12) ◽

pp. 986-989 ◽

Cited By ~ 57

Author(s):

Law M. ◽

Meltzer D. ◽

Cha S.

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Resonance Imaging ◽

Tumefactive Demyelinating Lesion

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Tumefactive demyelinating lesion: perfusion-weighted imaging findings

European Journal of Radiology Extra ◽

10.1016/j.ejrex.2004.12.007 ◽

2005 ◽

Vol 53 (3) ◽

pp. 95-98

Author(s):

Bahattin Hakyemez ◽

Cuneyt Erdogan ◽

Harun Yildiz ◽

Erol Bozdogan ◽

Mufit Parlak

Keyword(s):

Imaging Findings ◽

Perfusion Weighted Imaging ◽

Tumefactive Demyelinating Lesion

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Description of a Tumefactive Demyelinating Lesion Studied with Advanced Magnetic Resonance Techniques: A Clinical Report and Review of Literature

Annals of Cognitive Science ◽

10.36959/447/337 ◽

2017 ◽

Vol 1 (1) ◽

Author(s):

Simone Marta De ◽

Brogna Barbara ◽

Spitaleri Daniele Litterio ◽

Cicarelli Giulio ◽

Fantozzi Roberta ◽

...

Keyword(s):

Magnetic Resonance ◽

Clinical Report ◽

Review Of Literature ◽

Tumefactive Demyelinating Lesion

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Neuro-Oncology Dilemma: Tumour or Tumefactive Demyelinating Lesion

Journal of Multiple Sclerosis ◽

10.4172/2376-0389.1000137 ◽

2015 ◽

Vol 02 (02) ◽

Author(s):

Mohammad Abdoli Mark S Freedman

Keyword(s):

Tumefactive Demyelinating Lesion

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Monophasic, solitary tumefactive demyelinating lesion: neuroimaging features and neuropathological diagnosis

British Journal of Radiology ◽

10.1259/bjr/26682607 ◽

2004 ◽

Vol 77 (914) ◽

pp. 153-156 ◽

Cited By ~ 41

Author(s):

H M Tan ◽

L L Chan ◽

K L Chuah ◽

N S S Goh ◽

K K Tang

Keyword(s):

Neuropathological Diagnosis ◽

Tumefactive Demyelinating Lesion

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Pediatric Relapsing Anti-NMDAR Encephalitis Crossing with Tumefactive Demyelinating Lesion

Journal of Pediatric Neurology ◽

10.1055/s-0038-1636994 ◽

2018 ◽

Vol 17 (02) ◽

pp. 077-084

Author(s):

Sudarat Charoensanti ◽

Sutatip Pongcharoen ◽

Metha Apiwattanakul

Keyword(s):

Neuropsychiatric Symptoms ◽

Clinical Manifestations ◽

White Matter Lesions ◽

Subcortical White Matter ◽

Neurological Improvement ◽

Abnormal Movements ◽

Nmdar Encephalitis ◽

Autonomic Instability ◽

Tumefactive Demyelinating Lesion ◽

The Right

AbstractAnti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune encephalopathy characterized by neuropsychiatric symptoms, autonomic instability, and abnormal movements. Most children who undergo tumor removal and receive appropriate immunosuppressants have substantial neurological improvement. We report a 14-year-old girl with relapsing anti-NMDAR encephalitis who presented with paroxysmal tingling and weakness of the right lower limb. Despite long-term prophylaxis with immunotherapy (azathioprine), tumefactive demyelinating lesion and multifocal subcortical white matter lesions were identified on magnetic resonance imaging, which improved after high doses of steroid therapy. There may be overlap between the clinical manifestations of anti-NMDAR encephalitis and acquired demyelination syndromes in children.

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