Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis

  title={Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis},
  author={Claudia F. Lucchinetti and Ralitza H. Gavrilova and Imke Metz and Joseph E. Parisi and Bernd W. Scheithauer and S. Weigand and Kristine M. Thomsen and Jayawant Mandrekar and Ayşe G{\"u}l Koçak Altıntaş and Bradley James Erickson and Fatima Barbara K{\"o}nig and Caterina Giannini and Hans Lassmann and Linda Linbo and S. J. Pittock and Wolfgang Br{\"u}ck},
  pages={1759 - 1775}
Atypical imaging features of multiple sclerosis lesions include size >2 cm, mass effect, oedema and/or ring enhancement. This constellation is often referred to as ‘tumefactive multiple sclerosis’. Previous series emphasize their unifocal and clinically isolated nature, however, evolution of these lesions is not well defined. Biopsy may be required for diagnosis. We describe clinical and radiographic features in 168 patients with biopsy confirmed CNS inflammatory demyelinating disease (IDD… 

Is size an essential criterion to define tumefactive plaque? MR features and clinical correlation in multiple sclerosis

Evaluating the prevalence of tumefactive plaques in a selected population of 440 MS patients referred to a MS centre in Southern Italy between 2005 and 2014 suggests that lesions 0.5–2 cm and >2‬cm have similar MR features and clinical evolution.

Tumefactive Variant of Multiple Sclerosis – Two Case Reports

  • Medicine
  • 2020
Clinical and radiological features of this rare disease are emphasized and pinpoint examination procedures that could be used in differential diagnosis of tumefactive MS are presented.

Multiple Large Tumefactive MS Plaques in a Young Man: A Diagnostic Enigma and Therapeutic Challenge

A young man with fulminating neurological symptoms and multiple large tumefactive lesions on either hemisphere was presented and a course of steroid therapy was commenced which ended to considerable improvement and confirmed the diagnosis of tumef active MS.

Diagnostic Challenges and Radiological Spectrum of Tumefactive Multiple Sclerosis: A Case Report Study

A rare presentation of tumefactive multiple sclerosis is reported, which highlights the importance of differentiating TMS from other space-occupying lesions for prompt and proper management.

Clinical and radiological characteristics of tumefactive demyelinating lesions: follow-up study

There is a need for further studies to compare all the biological and immunological differences between MS and tumefactive lesion cases, in order to reveal whether there are different pathogenetic mechanisms involved.

Tumefactive idiopathic inflammatory demyelinating lesions: a diagnostic challenge

T tumefactive lesions can be the first manifestation of an IIDD, and advanced MR techniques such as dynamic susceptibility contrast (DSC) and proton MR spectroscopy(1H-MRS) can provide useful additional information in the diagnosis of pseudotumoural lesions.

Tumefactive multiple sclerosis or inflammatory demyelinating disease with large lesions?

  • H. Lassmann
  • Medicine, Psychology
    European journal of neurology
  • 2021
The results suggest that clinical disease progression and also clinically silent progression of brain damage are unusual in patients with tumefactive MS, and raises the question of whether these patients present with an aggressive exacerbation of classical MS or suffer from a disease that is distinct.

A Tumefactive Multiple Sclerosis Lesion in the Brain: An Uncommon Site with Atypical Magnetic Resonance Image Findings

A case of pathologically confirmed tumefactive MS in an uncommon location was reported, which showed atypical magnetic resonance (MR) imaging findings and a good response to steroid therapy.

Isolated tumefactive demyelinating lesions: diagnosis and long-term evolution of 16 patients in a multicentric study

Clinical and MRI characteristics and long-term follow-up of patients with isolated TDL, a rare diagnostic entity, are described, finding that almost one-third became MS whereas most of the patients had no further event.



Tumefactive demyelinating lesions: conventional and advanced magnetic resonance imaging

Repeated conventional magnetic resonance imaging techniques appear to have the potential to establish a correct diagnosis of tumefactive demyelinating lesions (TDLs), and awareness of these possibilities might obviate the need for biopsy at least in some cases in future.

Tumor-like multiple sclerosis (MS) lesions: neuropathological clues

Serial magnetic resonance imaging performed during steroid treatment, together with other paraclinical data, were sufficient for the final diagnosis of MS and can be indeed due to primary CNS vasculitis.

Correlation between neuroradiological and electrophysiological investigations in multiple sclerosis with features of a cerebral tumour.

Multiodal EPs, though disclosing subclinical dysfunction in the early stage of the disease, did not correlate with changes in neurological examination to follow-up, so they seem of no particular usefulness to serially monitor the clinical modification of MS.

Late-onset multiple sclerosis mimicking brain tumor: A case report

A case of rapidly progressive late-onset MS in an elderly patient with a large, single lesion on magnetic resonance imaging (MRI), which was difficult to distinguish from a brain tumor.

Acute demyelinating disease. Classification and non‐invasive diagnosis

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Tumefactive demyelinating lesions

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Correlation of magnetic resonance imaging and CSF findings in patients with acute monosymptomatic optic neuritis

Results of CSF had until now no marked predictive value for developing clinically definite MS, but all patients with idiopathic AMON had lesions on MRI at onset, illustrating the prognostic importance of MRI findings.

Demyelinating Disease Versus Tumor in Surgical Neuropathology: Clues to a Correct Pathological Diagnosis

The results emphasize the need to perform special stains (i.e., for myelin and axons) that demonstrate myelin loss and relative preservation of axons and allow a correct diagnosis.

Acute Demyelination, Neuropathological Diagnosis, and Clinical Evolution

A dense lymphocytic and plasma cell infiltrate is unusual in acute human demyelination and axonal injury is a frequent histologic finding in acute demyELination, it does not preclude a favorable clinical outcome.

Clinical course, pathological correlations, and outcome of biopsy proved inflammatory demyelinating disease

Most patients undergoing biopsy, who had pathologically confirmed demyelinating disease, were likely to develop MS and remain ambulatory after a median disease duration of 4.4 years, and data suggest that pathogenic implications derived largely from MS biopsy studies may be extrapolated to the general MS population.