scholarly journals A Blind Spot in the Diagnostic Field: The Challenging Diagnosis of Tumefactive Multiple Sclerosis

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Ramy Mando ◽  
Emile Muallem ◽  
Shaiva G. Meka ◽  
Ramona Berghea
Keyword(s):  
Multiple Sclerosis ◽  
Rare Variant ◽  
Blind Spot ◽  
Homonymous Hemianopia ◽  
Clinical Scenario ◽  
Radiological Features ◽  
Tumefactive Multiple Sclerosis

Tumefactive Multiple Sclerosis (TMS) is a rare variant with 1 per 1000 cases of MS and 3 per million cases per year. TMS can mimic clinical and radiological features of a neoplasm, infarction, or abscess and therefore can be diagnostically challenging for clinicians. We present a clinical scenario of a patient presenting with left homonymous hemianopia with atypical radiological features initially thought to be more consistent with neoplasm or infraction. Ultimately, biopsy was done which led to the diagnosis of tumefactive multiple sclerosis.

Clinical scenario of patients with multiple sclerosis (MS): A north Indian perspective

2017 ◽  
Vol 381 ◽  
pp. 240
Author(s):  
P. Banerjee ◽  
D. Khurana ◽  
B. Saikia ◽  
P. Singh ◽  
K. Jangra
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Scenario ◽  
Indian Perspective

scholarly journals Tumefactive Multiple Sclerosis in Taiwan

PLoS ONE ◽  
2013 ◽  
Vol 8 (7) ◽  
pp. e69919 ◽  
Author(s):  
Yi-Chun Kuan ◽  
Kai-Chen Wang ◽  
Wei-Hsin Yuan ◽  
Ching-Piao Tsai
Keyword(s):  
Multiple Sclerosis ◽  
Tumefactive Multiple Sclerosis

Tumefactive multiple sclerosis (TMS): A case series of this challenging variant of MS

2021 ◽  
Vol 48 ◽  
pp. 102699
Author(s):  
Joseph V. Villarreal ◽  
Maria J. Abraham ◽  
Joanne Allieza G. Acevedo ◽  
Prashant K. Rai ◽  
Neeharika Thottempudi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Series ◽  
Tumefactive Multiple Sclerosis

Increased accumulations of AMsopropyl-p-[123I]-iodoamphetamine related to tumefactive multiple sclerosis

2005 ◽  
Vol 19 (7) ◽  
pp. 603-606 ◽  
Author(s):  
Takao Sagiuchi ◽  
Hidehiro Oka ◽  
Satoshi Utsuki ◽  
Kimitoshi Sato ◽  
Ikuo Kobayasm ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Tumefactive Multiple Sclerosis

Fulminant tumefactive multiple sclerosis: Therapeutic implications of histopathology

2008 ◽  
Vol 255 (8) ◽  
pp. 1272-1273 ◽  
Author(s):  
M. R. Haupts ◽  
S. K. Schimrigk ◽  
N. Brune ◽  
A. Chan ◽  
G. Ahle ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Therapeutic Implications ◽  
Tumefactive Multiple Sclerosis

scholarly journals Tumefactive Multiple Sclerosis Clinically Mimicking Acute Stroke and Lesional Migration Along the Biopsy Tract: A Case Report

2019 ◽  
Vol 19 (2) ◽  
pp. 148-153
Author(s):  
Oranan Tritanon ◽  
Arunee Singhsnaeh ◽  
Jiraporn Laothamatus ◽  
Atthaporn Boongird ◽  
Disya Ratanakorn ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Acute Stroke ◽  
Demyelinating Disease ◽  
Internal Capsule ◽  
Chronic Inflammatory Cell ◽  
Left Frontal Lobe ◽  
Lentiform Nucleus ◽  
Mri Study ◽  
Tumefactive Multiple Sclerosis

Tumefactive multiple sclerosis is a form of demyelinating disease which patient can present with acute stroke. We reported a case of a 49-year-old woman with well controlled hypertension, who presented with right hemiplegia 15 hours prior to admission. The initial diagnosis of acute stroke was made. Emergency computed tomography showed hypodense lesion at the left lentiform nucleus and posterior limb of the left internal capsule. The magnetic resonance imaging (MRI) study showed hyperintense FLAIR lesion in the left lentiform nucleus, left internal capsule, left thalamus, and periventricular area of the left frontoparietal region, some areas of restricted diffusion and inhomogeneous enhancement. The MR spectroscopy (MRS) of the lesion showed increased choline peak, decreased creatine and NAA peaks, and maximal choline to creatine ratio 2.25. Her symptoms deteriorated with progressive headache and motor aphasia. The follow up MRI showed extension of the inhomogeneous enhancing lesion along the biopsy tract at the left frontal lobe with the enhancing and MR spectra pattern similar to the lesion. The craniotomy with left frontal lesion excision included the mass and the biopsy tract was done. The lesion showed acute and chronic inflammatory cell infiltration with macrophages, necrotic tissue and reactive gliosis. The further pathological worked up demonstrated foci of demyelination with relative axonal preservation, numerous CD68+ macrophages with intracyto-plasmic Luxol fast blue(+) myelin debris. Perivascular and parenchymal CD3+ T-cells were identified, especially in demyelinating foci. These findings supported the diagnosis of tumefactive multiple sclerosis. Her conditions were improved after treating with pulse methylprednisolone and intravenous immunoglobulin (IVIG). Follow up MRI study 4 months after treatment revealed almost resolution of the preexisting inhomogeneous enhancing lesion.

scholarly journals Plasma Exchange in a Patient with Tumefactive, Corticosteroid-Resistant Multiple Sclerosis

2015 ◽  
Vol 17 (5) ◽  
pp. 231-235 ◽  
Author(s):  
Kristin M. Ikeda ◽  
Donald H. Lee ◽  
J. Alexander Fraser ◽  
Seyed Mirsattari ◽  
Sarah A. Morrow
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Plasma Exchange ◽  
Magnetic Resonance Images ◽  
Periventricular White Matter ◽  
Disease Modifying Therapy ◽  
Natalizumab Treatment ◽  
Demyelinating Lesions ◽  
Recent Diagnosis ◽  
Tumefactive Multiple Sclerosis

Tumefactive multiple sclerosis (MS) is an aggressive form of MS that can be difficult to treat with standard therapies. In severe MS relapses, plasma exchange (PLEX) has shown some benefit, but reports of its use in patients with tumefactive MS are limited. This article describes the successful use of PLEX in a patient with tumefactive MS. A 46-year-old right-handed woman with a recent diagnosis of MS presented with drowsiness, dysarthria, horizontal nystagmus, and quadriparesis. Her brain magnetic resonance images demonstrated multiple tumefactive demyelinating lesions in the medulla, bilateral periventricular white matter, and corona radiata white matter. She was initially treated with a 10-day course of intravenous methylprednisolone without benefit; therefore, PLEX was initiated. After the second exchange, the patient started to improve and was discharged initially to rehabilitation and then home. She was started on disease-modifying therapy with natalizumab and did not experience further relapses but had slow clinical decline during the next year, which led to discontinuation of natalizumab treatment. PLEX may be used as second-line treatment in corticosteroid-resistant MS relapses, but there are limited reports of its use in patients with tumefactive MS. This patient presented with aggressive disease with multiple tumefactive lesions and did not respond to standard treatment with corticosteroids. PLEX was successful in improving her symptoms, allowing her to return home, although the disease progressed during the next year.

Retinal Findings in Two Patients With Tumefactive Multiple Sclerosis

2019 ◽  
Vol 39 (3) ◽  
pp. 399-400
Author(s):  
Adam Neuhouser ◽  
Riley Sanders ◽  
John R. Burks ◽  
Joseph Chacko
Keyword(s):  
Multiple Sclerosis ◽  
Tumefactive Multiple Sclerosis
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