engleski

Glioma in a patient with multiple sclerosis: a case report

Introduction: Glioma can mimick tumefactive type of demyelinative lesion. We report a young female who had coexistance of brain tumor and multiple sclerosis (MS). Case report: A 35-year-old female was admitted because of MS relapse. She had weakness of right extremities, facial paresis and motor aphasia. MS was diagnosed as she was 23, confirmed with laboratory and neuroimaging findings. She was taking betainterferon for last 6 years and treated with pulse corticosteroid therapy in relapses before. She had hypertension. As worsening appeared, MRI was done and revealed besides multiple demylinative lesions a hyperintensive inhomogenic enhancement in left frontoparietal lobe, what was described as tumefactive type of demylinative lesion. She was admitted to our Department again, and control MRI with paramagnetic contrast medium was done. It revealed expansive lesion with perifocal oedema and central necrosis which compressed ventricular system, what confirmed our suspicion on tumor. Neurosurgical operation was performed and patohistological finding showed demyelinative plaque with elements of glioma gradus III. Postoperative she had right hemiplegia and motor dysphasia, 6 months after rehabilitation she felt better and had hemiparesis with moderate speach impairment. Conclusion: Glioma is an uncommon coexisting finding in patients with MS. A typical symptoms, such as aphasia in this case, as well as typical MRI lesion should be carefully assessed and very often definitive diagnosis depends on pathohistological finding.

glioma; multiple sclerosis

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