Concurrent glioma and multiple sclerosis: A systematic review of case reports

• Published in: Multiple sclerosis and related disorders Vol. 84; p. 105455
• Main Authors: Nafari, Amirhossein, Ghaffary, Elham Moases, Shaygannejad, Vahid, Mirmosayyeb, Omid
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.04.2024
• Subjects: Cancer; Glioma; Multiple sclerosis; Tumor; Tumor; Multiple sclerosis; Glioma; Cancer
• ISSN: 2211-0348; 2211-0356; 2211-0356
• DOI: 10.1016/j.msard.2024.105455

•Glioma diagnosis in people with MS (pwMS) is challenging due to similar magnetic resonance imaging (MRI) characteristics with tumefactive demyelinating lesions (TDLs).•Glioma cases predominantly had contrast enhancement, followed by ring enhancement.•Glatiramer acetate (GA) and interferon (IFN)-ß were the most frequently used disease-modifying therapies (DMTs) among pwMS who developed gliomas. It is uncommon for individuals with demyelinating disease, notably multiple sclerosis (MS), to be diagnosed with intracranial gliomas. It has been debated whether or not the concurrence of these two disorders is accidental. Clinically, it may be challenging to diagnose someone who has MS and an intracranial tumor simultaneously. We conducted this systematic review to evaluate the glioma patients following MS. We collected 63 studies from 1672 databases from January 1990 to February 2023, and our inclusion criteria involved peer-reviewed case reports/series studies reporting concurrent MS and glioma in patients, considering various types of gliomas. We included 145 cases, 51% were women and 49 % were men, with an average age of 47.4 years. Common symptoms of glioma at admission included seizures (31.2 %), hemiparesis (15.6 %), and headache (14.3 %). 75 % of patients had primarily with relapsing-remitting MS (RRMS). MS treatments included interferon(IFN)-ß (44.6 %), glatiramer acetate (GA) (21.4 %), fingolimod (19.6 %), and natalizumab (19.6 %). The average time between MS and glioma diagnosis was 12.1 years, with various timeframes. Among the 59 reported cases, 45.8 % led to patient fatalities, while the remaining 54.2 % managed to survive. This co-occurrence, though rare, suggests potential underlying shared mechanisms or vulnerabilities, possibly at a genetic or environmental level. An interdisciplinary approach, combining the expertise of neurologists, oncologists, radiologists, and pathologists, is vital to ensure accurate diagnosis and optimal management of affected individuals. Nonetheless, there is still a significant lack of information regarding this phenomenon, necessitating large-scale population-based studies and experimental research.