title: Clinical and radiological characteristics of tumefactive demyelinating lesions: follow-up study.
abstract: BACKGROUND
  Demyelinating lesions over 20 mm in size, referred to as tumefactive demyelinating lesions, can be misdiagnosed as being either a tumor or an abscess. Although some radiological characteristics can help make a differential diagnosis easier, a cerebral biopsy may still be necessary.
  
  
  OBJECTIVE
  Our objective was to assess the clinical characteristics of tumefactive lesions, with or without a diagnosis of multiple sclerosis (MS), and present follow-up data for 54 patients with tumefactive lesions.
  
  
  METHODS
  Demographic, clinical, radiological and laboratory data were gathered and treatment responses were evaluated in a total of 54 patients from five medical centers.
  
  
  RESULTS
  Twenty-nine patients were diagnosed with tumefactive lesions at the onset, whereas 25 patients were diagnosed with tumefactive lesions after a diagnosis of MS. Median follow-up was 38.12 months. At final examination, 19 of the patients with a tumefactive lesion diagnosis at the onset eventually developed relapsing-remitting MS, while 10 remained with the condition as a clinically isolated syndrome. The tumefactive lesions studied were mostly focal, with closed-ring enhancement. We found that oligoclonal band positivity was less frequent in the patients with tumefactive onset.
  
  
  CONCLUSIONS
  Although our demographic data were similar to formerly collected Turkish MS data, we found that the distribution of the patients' clinical course differed if there was an absence of primary progressive MS and that there was a lower frequency of secondary progressive MS cases in our group of patients. We believe that less frequent oligoclonal band positivity and the difference we witnessed in the clinical course of disease in our study groups suggest that there is a need for further studies to compare all the biological and immunological differences between MS and tumefactive lesion cases, in order to reveal whether there are different pathogenetic mechanisms involved.
authors.affiliation: Department of Neurology, Istanbul University, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Altintas
authors.forename: B
authors.initials: B
authors.lastname: Petek
authors.forename: N
authors.initials: N
authors.lastname: Isik
authors.forename: M
authors.initials: M
authors.lastname: Terzi
authors.forename: F
authors.initials: F
authors.lastname: Bolukbasi
authors.forename: M
authors.initials: M
authors.lastname: Tavsanli
authors.forename: S
authors.initials: S
authors.lastname: Saip
authors.forename: C
authors.initials: C
authors.lastname: Boz
authors.forename: T
authors.initials: T
authors.lastname: Aydin
authors.forename: O
authors.initials: O
authors.lastname: Arici-Duz
authors.forename: F
authors.initials: F
authors.lastname: Ozer
authors.forename: A
authors.initials: A
authors.lastname: Siva
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology; D001922:Brain Abscess / Q000175:diagnosis; D001932:Brain Neoplasms / Q000175:diagnosis; D003711:Demyelinating Diseases / Q000175:diagnosis* / Q000276:immunology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000276:immunology; D043025:Oligoclonal Bands; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D043025:Oligoclonal Bands