title: Cerebral ependymoma in a patient with multiple sclerosis case report and critical review of the literature.
abstract: BACKGROUND
  The concurrence of multiple sclerosis (MS) and brain tumors is a rare but well-recognized condition. The radiologic evidence of the progressive evolution of a mega-plaque in a tumor has never been described. We report the first case of such an occurrence.
  
  
  METHODS
  A 27-year-old woman with a diagnosis of MS was referred to us for an intense frontal headache. Magnetic resonance imaging showed a mass lesion in correspondence of a black hole lesion previously diagnosed. The patient was operated on, with complete removal of the tumor documented by an intraoperative MRI. The histologic examination evidenced an ependymoma. Postoperative radiotherapy was performed.
  
  
  RESULTS
  The patient is well and recurrence-free at 2 years follow-up.
  
  
  CONCLUSIONS
  The present case, documenting the transformation of a mega-plaque into a tumor, suggests a cause-effect relationship between MS and brain tumors.
authors.affiliation: Department of Neurological Sciences, St Andrea Hospital, La Sapienza University Medical School, 00189 Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Acqui
authors.forename: Emanuela
authors.initials: E
authors.lastname: Caroli
authors.forename: Domenica
authors.initials: D
authors.lastname: Di Stefano
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrante
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D004806:Ependymoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000150:complications* / Q000473:pathology