A challenging case of concurrent multiple sclerosis and anaplastic astrocytoma.
Anaplastic astrocytoma
Gamma knife radiosurgery
Magnetic resonance imaging
Multiple sclerosis
Oligodendroglioma
Tumefactive multiple sclerosis
Journal
Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836
Informations de publication
Date de publication:
2019
2019
Historique:
received:
29
10
2018
accepted:
08
03
2019
entrez:
5
10
2019
pubmed:
5
10
2019
medline:
5
10
2019
Statut:
epublish
Résumé
Cases of gliomas coexisting with multiple sclerosis (MS) have been described over the past few decades. However, due to the complex clinical and radiological traits inherent to both entities, this concurrent phenomenon remains difficult to diagnose. Much has been debated about whether this coexistence is incidental or mirrors a poorly understood neoplastic phenomenon engaging glial cells in the regions of demyelination. We present the case of a 41-year-old patient diagnosed with a left-sided frontal contrast enhancing lesion initially assessed as a tumefactive MS. Despite systemic treatment, the patient gradually developed signs of mass effect, which led to decompressive surgery. The initial microscopic evaluation demonstrated the presence of MS and oligodendroglioma; the postoperative evolution proved complex due to a series of MS-relapses and tumor recurrence. An ulterior revaluation of the samples for the purpose of this report showed an MS-concurrent anaplastic astrocytoma. We describe all relevant clinical aspects of this case and review the medical literature for possible causal mechanisms. Although cases of concurrent glioma and MS remain rare, we present a case illustrating this phenomenon and explore a number of theories behind a potential causal relationship.
Sections du résumé
BACKGROUND
BACKGROUND
Cases of gliomas coexisting with multiple sclerosis (MS) have been described over the past few decades. However, due to the complex clinical and radiological traits inherent to both entities, this concurrent phenomenon remains difficult to diagnose. Much has been debated about whether this coexistence is incidental or mirrors a poorly understood neoplastic phenomenon engaging glial cells in the regions of demyelination.
CASE DESCRIPTION
METHODS
We present the case of a 41-year-old patient diagnosed with a left-sided frontal contrast enhancing lesion initially assessed as a tumefactive MS. Despite systemic treatment, the patient gradually developed signs of mass effect, which led to decompressive surgery. The initial microscopic evaluation demonstrated the presence of MS and oligodendroglioma; the postoperative evolution proved complex due to a series of MS-relapses and tumor recurrence. An ulterior revaluation of the samples for the purpose of this report showed an MS-concurrent anaplastic astrocytoma. We describe all relevant clinical aspects of this case and review the medical literature for possible causal mechanisms.
CONCLUSION
CONCLUSIONS
Although cases of concurrent glioma and MS remain rare, we present a case illustrating this phenomenon and explore a number of theories behind a potential causal relationship.
Identifiants
pubmed: 31583163
doi: 10.25259/SNI_176_2019
pii: SNI-10-166
pmc: PMC6763678
doi:
Types de publication
Case Reports
Langues
eng
Pagination
166Informations de copyright
Copyright: © 2019 Surgical Neurology International.
Déclaration de conflit d'intérêts
None of the authors has any conflicts of interest to disclose.
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