Publication details

Case report: Diagnostic challenge: a new multiple sclerosis "relapse" leading to the diagnosis of anaplastic astrocytoma

Authors

PETRÁŠOVÁ Martina ŠROTOVÁ Iva KOLČAVA Jan ŠTOURAČ Pavel HYNKOVÁ Ludmila KEŘKOVSKÝ Miloš PIKULOVÁ Hana NEUMAN Eduard KŘEN Leoš VLČKOVÁ Eva

Year of publication 2024
Type Article in Periodical
Magazine / Source Frontiers in Neurology
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1324269/full
Doi http://dx.doi.org/10.3389/fneur.2023.1324269
Keywords astrocytoma; multiple sclerosis; magnetic resonance imaging; positron-emission tomography; case report
Description Cerebral tumors and multiple sclerosis (MS) can show overlapping clinical and magnetic resonance imaging (MRI) features and even occur concurrently. Due to the emergence of new symptoms, not usually MS related, an MRI was conducted in a 29-year-old woman with relapsing-remitting MS and showed a significant size progression of a parieto-occipital lesion, with mild clinical correlates, such as blurred vision, difficulty in speaking, and headache. Contrast-enhanced MRI and fluorothymidine positron-emission tomography (PET) did not point toward neoplasm, a lesion biopsy, however, showed astrocytoma, which was confirmed as grade III astrocytoma after the radical resection of the tumor. In the case of an atypical lesion, a tumor should be considered in patients with MS. A small fraction of high-grade gliomas show no enhancement on MRI and no hypermetabolism on PET. Biopsy proved to be the essential step in a successful diagnostic workup. To the best of our knowledge, this is the first case of anaplastic astrocytoma with these radiological features reported in a patient with MS.
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