Tumefactive multiple sclerosis

Abstract

Tumefactive multiple sclerosis (MS) is a subtype of atypical and rare MS that presents with tumor-like lesions in the central nervous system. The lesions may demonstrate a mass effect, edema, with ring enhancement. They can be mistaken for brain tumors or brain abscesses radiologically and clinically. Here we describe an instructive case of a 55-year-old woman with tumefactive MS who presented with occasional numbness in her right arm and leg, headache, thought confusion, and blurred vision for 2 years.

Keywords: Abscess; demyelinating; tumor.

Figure 1.

Lesions consistent with tumefactive multiple sclerosis were noted on MRI diffusion sequence of the (a) right periventricular region and (b) left half of the mesencephalon. (c) Diffusion restricted lesions in the left mid and poterior parietal regions.

Figure 2.

Intermediate ring-enhancing lesions denoted by arrows in the right frontal lobe and the left half of the mesencephalon demonstrate mass effect. A short segment lesion in the left half of the cervical C4 spine is also highlighted.