Demyelinating Pseudotumor: A Case Report

ABSTRACT

The demyelinating diseases of the central nervous system(CNS), of which multiple sclerosis is the most common, have the characteristics which are selective loss of myelin with relative axonal preservation on the histopathologic findings, variable clinical findings and unknown pathophysiology. Occasionally, the clinical features, radiological and histopathological findings of patients with demyelinating disorders of the CNS mimic the brain tumor. Therefore, it may lead to erroneous surgical intervention as well as radiotherapy. The authors report a 26-year-old woman with demyelinating pseudotumor who presented with a generalized tonicclonic type seizure and left hemiparesis. Computerized tomography and magnetic resonance imaging of the patient revealed about 3X3X2cm sized enhanced mass lesion in the right frontal lobe with severe perifocal brain edema. This space-occupying lesion was resected subtotally and confirmed as the demyelinating pseudotumor via various neurohistochemical stains. Uncommonly, large focal cerebral demyelinating lesions presented as brain tumors clinically and radiologically. Therefore, it is mandatory to make a more careful diagnosis to differentiate the demyelinating pseudotumor from other true brain tumors before undergoing the surgery.