Pearls & Oy-sters: Diagnosis of Pediatric Tumefactive Multiple Sclerosis With MRI Biomarkers.
Kelsey Mackenzie Barter, Aye Thant, Monye Pitt et al.
✦ AI-curated · Sources linked
Case in brief
A 16-year-old boy presented with subacute headaches, cognitive difficulties, dizziness, blurry vision, right arm weakness, numbness, and gait issues. MRI revealed multilobulated, contrast-enhancing lesions in the left frontal lobe and periventricular regions. After initial improvement with steroids, he experienced a recurrence. A follow-up MRI showed lesions with central vein sign, leading to a diagnosis of multiple sclerosis based on the 2024 McDonald criteria.
What made this case unusual
The presence of central vein sign (CVS) in the lesions was pivotal for the diagnosis, distinguishing tumefactive multiple sclerosis from a tumor.
Diagnostic / clinical pearl
Recognition of the central vein sign on MRI is crucial for differentiating tumefactive multiple sclerosis from neoplastic processes, facilitating timely and appropriate treatment.
Why it matters
Accurate diagnosis of tumefactive multiple sclerosis can prevent unnecessary interventions and ensure prompt initiation of effective therapy.