Presentation
Left sided weakness
Patient Data
Age: 55 years
Gender: Male
From the case:
Tumefactive demyelination
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Axial T1
MRI from another institution demonstrates a large rounded area of edema with incomplete rim enhancement in the right frontal lobe has appearances most in keeping with tumefactive demyelination. A few other white matter lesions are also present.
Because the intial scan was reported as likely representing a glioma, the mass was biopsied. Histological examination confirmed the diagnosis of tumefactive demyelination.
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Sagittal FLAIR
MRI 13 years later shows typical changes of multiple sclerosis with multiple white matter plaques. The area of the previous biopsy and tumefactive demyelination is a gliotic cavity.
Case Discussion
The patient remains well, although they have ongoing multiple sclerosis.
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