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. 2009 Dec 21:2:9366.
doi: 10.1186/1757-1626-2-9366.

Homonymous hemianopsia as the leading symptom of a tumor like demyelinating lesion: a case report

Maria Eleptheria Evangelopoulos  1 , Dimitrios Stergios Evangelopoulos, Costas Potagas, Costantinos Sfagos
Affiliations

Homonymous hemianopsia as the leading symptom of a tumor like demyelinating lesion: a case report

Maria Eleptheria Evangelopoulos et al. Cases J. .

Abstract

Introduction: Differential diagnosis of a cerebral lesion can prove to be a very challenging task for the treating physician. Many non-neoplastic neurological diseases can mimic brain neoplasms on neuroimaging.

Case presentation: A previously healthy 23-year-old male, presented with blurred vision to the Emergency Department of our Hospital. After initial clinical and serological examination, he was admitted to our clinic for further investigation. Neurological examination showed left homonymous hemianopsia. Brain MRI revealed edema of the right parietal lobe, compressing the posterior region of the right ventricle. Serum viral, immunological and paraneoplasmatic testing were negative. Spectroscopic MRI described the lesions as tumefactive demyelinated plaques. After treating the patient with intravenous corticosteroids, his symptoms rapidly improved and the extensive lesion of the parietal lobe decreased.

Conclusion: In case of young patients with tumor-like lesions, demyelination should always be considered in the differential diagnosis.

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Figures

Figure 1
Figure 1
MRI upon admission: T2W & Flair sequences revealed a lesion extending from the right parietal to the temporal lobe, compressing the posterior aspect of the right ventricle. No lesion showed gadolinium enhancement.
Figure 2
Figure 2
Visual fields revealing left homonymous hemianopsia.
Figure 3
Figure 3
MRI spectroscopy.
Figure 4
Figure 4
MRI spectroscopy.
Figure 5
Figure 5
MRI spectroscopy.
Figure 6
Figure 6
MRI at 5 year follow-up.
See this image and copyright information in PMC

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References

    1. Omuro MPA, Leite CC, Mokhtari K, Delattre JY. Pitfalls in the diagnosis of brain tumours. Lancet Neurol. 2006;5:937–948. doi: 10.1016/S1474-4422(06)70597-X. - DOI - PubMed
    1. Tavee JO, Bae CJ, Prayson RA, Pioro EP. A 25-year-old woman with hemiparesis and a solitary brain lesion. Cleve Cl J Med. 2002;69:389–394. doi: 10.3949/ccjm.69.5.389. - DOI - PubMed
    1. Vuorinen V, Hinkka S, Farkkila M, Jaaskelainen J. Debulking or biopsy of malignant glioma in elderly people: a randomised study. Acta Neurochir (Wien) 2003;145:5–10. doi: 10.1007/s00701-002-1030-6. - DOI - PubMed
    1. Stranjalis G, Protopapa D, Sakas DE, Chondros D. Stereotactic biopsy in the era of advanced neuroimaging. Does the minimal therapeutic gain justify its current wide use? Minim Invasive Neurosurg. 2003;46:90–93. doi: 10.1055/s-2003-39346. - DOI - PubMed
    1. Schrader B, Barth H, Lang EW, Buhl R, Hugo HH, Biederer J, Mehdorn HM. Spontaneous intracranial haematomas caused by neoplasms. Acta Neurochir (Wien) 2000;142:979–985. doi: 10.1007/s007010070052. - DOI - PubMed

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