Park Seong Hyun, Hwang Jeong Hyun
Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea.
Brain Tumor Res Treat. 2021 Apr;9(1):35-39. doi: 10.14791/btrt.2021.9.e1.
We report a rare case of neuromyelitis optica spectrum disorders (NMOSD), mimicking multiple brain tumors. A 53-year-old woman presented with weakness and paresthesia in her right arm and leg. Upon admission, brain MRI showed about 10 multiple brain tumors, which had to be differentiated from multiple brain metastases, lymphoma, and high-grade glioma in both hemispheres. No primary cancer was found in the chest-abdomen-pelvis CT. Subsequent spine MRI revealed multifocal cord signal change involving C2-T7, suggesting myelitis. A decrease in visual acuity was noted when taking a medical history, and optic neuritis was diagnosed upon ophthalmologic examination. With clinical and radiological appearances, multiple brain and spinal cord lesions have been diagnosed as NMOSD. Steroid and immunosuppressive drugs were administered. We should consider the possibility of an autoimmune disease, such as NMOSD, involving the optic nerve, spinal cord, and central nervous system when multiple hemispheric tumefactive lesions are observed.
我们报告了一例罕见的视神经脊髓炎谱系障碍（NMOSD），表现类似多发性脑肿瘤。一名53岁女性出现右臂和右腿无力及感觉异常。入院时，脑部MRI显示约10个多发性脑肿瘤，必须与双侧半球的多发性脑转移瘤、淋巴瘤和高级别胶质瘤相鉴别。胸腹部盆腔CT未发现原发性癌症。随后的脊柱MRI显示C2 - T7节段有多灶性脊髓信号改变，提示脊髓炎。病史询问时发现视力下降，眼科检查诊断为视神经炎。结合临床和影像学表现，多发性脑和脊髓病变被诊断为NMOSD。给予了类固醇和免疫抑制药物治疗。当观察到多个半球肿胀性病变时，应考虑自身免疫性疾病的可能性，如涉及视神经、脊髓和中枢神经系统的NMOSD。
