Multifocal Tumefactive Demyelination - Magnetic Resonance Imaging Features
Journal Title: Indian Journal of Applied Radiology - Year 2018, Vol 4, Issue 1
Abstract
Tumefactive Demyelinating Lesion (TDL), also referred as Monofocal Acute Inflammatory Demyelination (MAID), is a focal aggressive demyelination, usually manifesting as a solitary lesion or as few separate lesions greater than 2 cm that may mimic a tumor on neuro-imaging and pose a diagnostic challenge to the clinician as well as the radiologist. A precise diagnosis of TDL is absolutely essential as the management varies in TDL and Tumors. The magnetic resonance imaging (MRI) features suggestive of TDL include large white matter lesions with little mass effect or vasogenic edema, incomplete or open-ring enhancement, high central Apparent Diffusion Coefficients (ADC) and low relative Cerebral Blood Volume (rCBV). We report a 39 years old female patient presenting with gradual progression of weakness of left upper & lower limb followed by giddiness, headache & deviation of angle of mouth to right side, since 10 days, who had multifocal TDL mimicking metastatic brain tumor on imaging. The typical MRI features of the rare disease helped us to rule out tumor and spared the patient from invasive procedure such as biopsy and radiation from radiotherapy. Patient showed good improvement with corticosteroid therapy.
Authors and Affiliations
Kumar K
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