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

• Published in: Curēus (Palo Alto, CA) Vol. 14; no. 11; p. e31899
• Main Authors: Muddassir, Rabia, Badirah, Sara B, Alshahrani, Ghada M, Eltahan, Ayman A
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 26.11.2022; Cureus
• Subjects: Brain cancer; Case reports; Chronic illnesses; Edema; Laboratories; Lymphoma; Medical diagnosis; Multiple sclerosis; Nervous system; Neurology; Patients; Radiology; Speaking; Stroke; Tomography; demyelinating disease; tumefactive; demyelination; multiple sclerosis; tumefactive demyelination
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.31899

Multiple sclerosis (MS) is a chronic disease of the central nervous system (CNS). It has many types, which include tumefactive multiple sclerosis (TMS), one of the most uncommon types. We present the case of a 36-year-old woman who presented with right-sided numbness of the body. Magnetic resonance imaging (MRI) of the brain revealed a large mass (3 cm × 2.5 cm) in the deep white matter of the right frontal lobe along with smaller lesions of variable sizes. After considering the MRI features, the CSF results, and the improvement of the symptoms with a high dose of steroids, the diagnosis of tumefactive multiple sclerosis was made. A biopsy was not done on our patient as the symptoms resolved after treatment, although sometimes it is necessary for diagnosing tumefactive multiple sclerosis to rule out tumors or abscesses. The current study described the clinical presentation, the role of imaging, the differential diagnosis, and the treatment options. This case report aimed to report a rare presentation of TMS, which highlights the importance of differentiating TMS from other space-occupying lesions for prompt and proper management.