title: Tumefactive multiple sclerosis requiring emergency craniotomy: case report and literature review.
abstract: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system, characterized by focal neurological dysfunction with a relapsing and remitting course. Tumor-like presentation of MS (or "tumefactive"/"pseudotumoral" presentation) has been described before with a certain frequency; it consists of a large single plaque (>2cm) with presence of edema and mass effect and it is hard to distinguish from a brain tumor. However, we present a very rare case of a 53-year-old woman with a right temporal mass that turned out to be a MS plaque, who deteriorated within hours (brain herniation with loss of consciousness and unilateral mydriasis) and required an emergency craniotomy. We also present a review of the literature. It appears that only 4 cases of emergency craniotomy/craniectomy required in a patient with a tumor-like MS plaque have been reported before.
authors.affiliation: Department of Neurosurgery, University Hospital 12 de Octubre, Complutense University of Madrid, School of Medicine, Madrid, Spain. Electronic address: pablommunarriz@gmail.com.
authors.forename: Pablo M
authors.initials: PM
authors.lastname: Munarriz
authors.forename: Ana M
authors.initials: AM
authors.lastname: Castaño-Leon
authors.forename: Rafael
authors.initials: R
authors.lastname: Martinez-Perez
authors.forename: Aurelio
authors.initials: A
authors.lastname: Hernandez-Lain
authors.forename: Ana
authors.initials: A
authors.lastname: Ramos
authors.forename: Alfonso
authors.initials: A
authors.lastname: Lagares
mesh_terms: D003399:Craniotomy; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000601:surgery*
keywords: Esclerosis múltiple; Esclerosis múltiple pseudotumoral; Esclerosis múltiple tumefacta; Multiple sclerosis; Pseudotumoral multiple sclerosis; Tumefactive multiple sclerosis