title: Late-onset multiple sclerosis mimicking brain tumor: a case report.
abstract: Multiple sclerosis (MS) is a demyelinating disease that predominantly affects those aged in their twenties to their forties. We recently observed a case of rapidly progressive late-onset MS in an elderly patient with a large, single lesion on magnetic resonance imaging (MRI), which was difficult to distinguish from a brain tumor. This case is reported here with a review of the literature. A 69-year-old woman who presented with left hemiparesis was admitted to our institute. A tumor lesion was strongly suspected from the MRI finding of a large solitary lesion adjacent to the right lateral ventricle. Her left hemiparesis became rapidly worse, so we decided to perform stereotactic biopsy. Histopathological examination indicated that the patient had a demyelinating disease such as multiple sclerosis. Steroid pulse therapy was started after the operation and led to a marked improvement of the symptoms. With follow-up for more than 1 year after discharge, she has shown no sign of relapse. Late-onset MS should be suspected if edema or mass effect is not visualized around the lesion on MRI, bearing in mind that late-onset MS can have a progressive course in elderly patients.
authors.affiliation: Department of Neurosurgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Iwamoto
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Oka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Utsuki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ozawa
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fujii
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D011859:Radiography