Monophasic, solitary tumefactive demyelinating lesion: neuroimaging features and neuropathological diagnosis.
The characteristic clinicoradiological findings of multiple sclerosis and acute disseminated encephalomyelitis (ADEM), demonstrating a recurrent progressive course in the former and monophasicity in the latter associated with multiple discrete white matter lesions with variable enhancement on MRI, are not a diagnostic challenge. On the other hand, the less typical radiological presentation of a solitary tumefactive demyelinating lesion mimics a neoplasm, and often necessitates a biopsy. Nonetheless, histopathological examination is an imperfect gold standard and the recognition of certain imaging features may facilitate the correct diagnosis.
Tan
H M
HM
Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 168609.
Chan
L L
LL
Chuah
K L
KL
Goh
N S S
NS
Tang
K K
KK
D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis; D003711:Demyelinating Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D011522:Protons; D014057:Tomography, X-Ray Computed / Q000379:methods
D011522:Protons