Basić Kes Vanja, Cesarik Marijan, Corić Lejla, Zavoreo Iris, Rotim Kresimir, Beros Vili, Pazanin Leo, Drnasin Sara, Demarin Vida
University Department of Neurology, Referral Center for Neurovascular Disorders and Referral Center for Headache of the Ministry of Health of the Republic of Croatia, Zagreb, Croatia.
Acta Clin Croat. 2012 Mar;51(1):113-6.
Multiple sclerosis is a chronic demyelinating disease of the central nervous system. Tumor-like manifestation of multiple sclerosis is one of the rare clinical variants and it is frequently misdiagnosed. This is a report on a 45-year-old man who presented with right-sided hemiparesis. Initial computed tomography and magnetic resonance imaging studies of the brain revealed a large hyperintense signal lesion in the left hemisphere surrounding the cerebral edema. Low grade glioma was among the likely differential diagnoses. The patient underwent surgery. Brain biopsy showed demyelination. Lumbar puncture was performed and cerebrospinal fluid was positive for intrathecal synthesis of immunoglobulins. Other findings were compatible with the unusual form of multiple sclerosis. This case report illustrates a demyelinating process mimicking tumor lesions of the brain and it is of high importance to consider the diagnosis of multiple sclerosis on differential diagnosis of a tumor-like lesion of the central nervous system.
多发性硬化症是一种中枢神经系统的慢性脱髓鞘疾病。多发性硬化症的肿瘤样表现是一种罕见的临床变体,常被误诊。本文报告一例45岁男性,表现为右侧偏瘫。最初的脑部计算机断层扫描和磁共振成像研究显示左半球有一个围绕脑水肿的大的高信号病变。低度胶质瘤是可能的鉴别诊断之一。患者接受了手术。脑活检显示脱髓鞘。进行了腰椎穿刺,脑脊液鞘内免疫球蛋白合成呈阳性。其他发现与多发性硬化症的不寻常形式相符。本病例报告说明了一种模仿脑肿瘤病变的脱髓鞘过程,在中枢神经系统肿瘤样病变的鉴别诊断中考虑多发性硬化症的诊断非常重要。