Progressive Tumefactive Demyelination as the Only Result of Extensive Diagnostic Work-Up: A Case Report

Pavel Štourač; Jan Kolčava; Miloš Keřkovský; Tereza Kopřivová; Leoš Křen; Josef Bednařík

doi:10.3389/fneur.2021.701663

Progressive Tumefactive Demyelination as the Only Result of Extensive Diagnostic Work-Up: A Case Report

Front Neurol. 2021 Jul 8:12:701663. doi: 10.3389/fneur.2021.701663. eCollection 2021.

Authors

Pavel Štourač^{1

2}, Jan Kolčava^{1

2}, Miloš Keřkovský^{1

3}, Tereza Kopřivová^{1

3}, Leoš Křen^{1

4}, Josef Bednařík^{1

2}

Affiliations

¹ Faculty of Medicine, Masaryk University Brno, Brno, Czechia.
² Department of Neurology, University Hospital Brno, Brno, Czechia.
³ Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno, Czechia.
⁴ Department of Pathology, University Hospital Brno, Brno, Czechia.

Abstract

Tumefactive demyelinating lesions belong to the rare variants of multiple sclerosis, posing a diagnostic challenge since it is difficult to distinguish them from a neoplasm or other brain lesions and they require a careful differential diagnosis. This contribution presents the case report of a young female with progressive tumefactive demyelinating brain and spinal cord lesions. An extensive diagnostic process including two brain biopsies and an autopsy did not reveal any explanatory diagnosis other than multiple sclerosis. The patient was treated by various disease-modifying treatments without significant effect and died from ascendent infection via ventriculoperitoneal shunt resulting in Staphylococcus aureus meningitis.

Keywords: case report; demyelinating diseases; multiple sclerosis; neuropathology; neuroradiology.

Publication types

Case Reports