title: Occurrence and long-term outcome of tumefactive demyelinating lesions in multiple sclerosis.
abstract: Although tumefactive multiple sclerosis is a well recognized variant of multiple sclerosis, prognostic uncertainty still exists about long term prognosis. The aim of this study was to estimate the occurrence and long term outcome of tumefactive demyelinating lesions (TDLs) in a cohort of multiple sclerosis patients. We reviewed brain MRI of 443 patients referred to our MS clinic. All patients meeting the McDonald criteria for multiple sclerosis and showing at least one TDL were included. Kaplan-Meier estimates of disease-free survival in patient cohort were compared with control group without TDLs using a log-rank test. Seven cases with TDLs were identified (occurrence 1.58 %). Tumefactive demyelinating lesion recurrence was 16.6 %. Cumulative proportion of patients free from clinical relapse and from new T2 lesions was lower in the control group although not reaching statistical significance (30 vs 50 %; P = 0.666 and 21.7 vs 33.3 %; P = 0.761, respectively). Disability progression analysis showed a not significant trend towards lower probability of remaining progression free for TDL patients (50 vs 61 %; P = 0.295). Occurrence of tumefactive demyelinating lesions in our cohort was higher than those reported in other studies. Overall, TDLs were not predictive of poor outcome in terms of disability progression.
authors.affiliation: Department of Neurology, Multiple Sclerosis Center, San Salvatore Hospital, Via Vetoio 1, 67100, L'Aquila, Italy. rocco.totaro@univaq.it.
authors.forename: Rocco
authors.initials: R
authors.lastname: Totaro
authors.affiliation: Department of Neurology, Multiple Sclerosis Center, San Salvatore Hospital, Via Vetoio 1, 67100, L'Aquila, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Di Carmine
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Splendiani
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Torlone
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Patriarca
authors.affiliation: Department of Neurology, Multiple Sclerosis Center, San Salvatore Hospital, Via Vetoio 1, 67100, L'Aquila, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Carrocci
authors.affiliation: Department of Neurology, Multiple Sclerosis Center, San Salvatore Hospital, Via Vetoio 1, 67100, L'Aquila, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Sciamanna
authors.affiliation: Department of Medicine, Health and Environment Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Marini
authors.affiliation: Department of Clinical and Applied Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Carolei
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003711:Demyelinating Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D016016:Proportional Hazards Models; D016019:Survival Analysis; D055815:Young Adult
keywords: Long-term follow-up; Magnetic resonance imaging; Multiple sclerosis; Prevalence; Tumefactive demyelinating lesions