Abstract
Rare forms of demyelinating disease such as Balò's concentric sclerosis or Schilder's disease may simulate brain tumors, both clinically and on the computed tomography (CT) and magnetic resonance imaging (MRI). Even the histopathological diagnosis after a biopsy is not entirely reliable. We report three cases of pseudotumoral demyelinating disorders having required a stereotaxic biopsy, one of which was erroneously diagnosed as a malignant astrocytoma. We describe MRI especially the intense contrast enhancement with ill-defined margins, and the mild mass effect. We then detail the histopathological processes upon which differential diagnosis with a tumor can be based.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Zhou MJ: (Encephalitis periaxialis concentrica (Balo's disease) - report of a case (author's transl)). Zhonghua Shen Jing Jing Shen Ke Za Zhi 13: 114–116, 1981
Schilder P: Zur kenntnis der sogenannten difusen sklerose. Z Ges Neurol Psychiatr 10: 1–60, 1912
Kalyan-Raman UP, Garwacki DJ, Elwood PW: Demyelinating disease of corpus callosum presenting as glioma on magnetic resonance scan: a case documented with pathological findings. Neurosurgery 21: 247–250, 1987
Rieth KG, Di Chiro G, Cromwell LD, McKeever PE, Kornblith PL, Kufta CV, Pleet AB: Primary demyelinating disease simulating glioma of the corpus callosum: report of three cases. J Neurosurg 55: 620–624, 1981
Zagzag D, Miller DC, Kleinman GM, Abati A, Donnenfeld H, Budzilovich GN: Demyelinating disease versus tumor in surgical neuropathology. Clues to a correct pathological diagnosis.Am J Surg Pathol 17: 537–545, 1993
Castaigne P, Escourolle R, Chain F, Foncin JF, Gray F, Sauron B, Duyckaerts C: (Balo's concentric sclerosis). Rev Neurol 140: 479–487, 1984
Garbern J, Spence AM, Alvord EC, Jr: Balo's concentric demyelination diagnosed premortem. Neurology 36: 1610–1614, 1986
Mastrostefano R, Occhipinti E, Bigotti G, Pompili A: Multiple sclerosis plaque simulating cerebral tumor: case report and review of the literature. Neurosurgery 21: 244–246, 1987
Vital A, Vital C, Delisle MB, Loiseau H, Rummens C, Mouton L: (Pseudo-tumoral lesions of multiple sclerosis). Ann Pathol 15: 142–146, 1995
Eblen F, Poremba M, Grodd W, Opitz H, Roggendorf W, Dichgans J: Myelinoclastic diffuse sclerosis (Schilder's disease): cliniconeuroradiologic correlations. Neurology 41: 589–591, 1991
Lhermitte F, Escourolle R, Hauw JJ, Gray F, Serdaru M, Lyon-Caen O: (Necrotic aspects of multiple sclerosis and Schilder's disease (author's transl)). Rev Neurol 137: 589–600, 1981
Korte JH, Bom EP, Vos LD, Breuer TJ, Wondergem JH: Balo concentric sclerosis: MR diagnosis. AJNR Am J Neuroradiol 15: 1284–1285, 1994
Kim MO, Lee SA, Choi CG, Huh JR, Lee MC: Balo's concentric sclerosis: a clinical case study of brain MRI, biopsy, and proton magnetic resonance spectroscopic findings. J Neurol Neurosurg Psychiatry 62: 655–658, 1997
Caracciolo JT, Murtagh RD, Rojiani AM, Murtagh FR: Pathognomonic MR imaging findings in Balo concentric sclerosis. Am J Neuroradiol 22: 292–293, 2001
Gray F, Leger JM, Duyckaerts C, Bor Y: (Balo's concentric sclerosis: lesions restricted to the pons). Rev Neurol 141: 43–45, 1985
Gherardi R, Salama J, Gray F, Kemeny JL, Delaporte P, Poirier J, Cambier J: [Cerebral lymphoma associated with lesions of multiple sclerosis]. Rev Neurol 141: 456–463, 1985
van derVelden M, Bots GT, Endtz LJ: Cranial CT in multiple sclerosis showing a mass effect. Surg Neurol 12: 307–310, 1979
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Heyman, D., Delhaye, M., Fournier, D. et al. Pseudotumoral demyelination: a diagnosis pitfall (report of three cases). J Neurooncol 54, 71–76 (2001). https://doi.org/10.1023/A:1012534404328
Issue Date:
DOI: https://doi.org/10.1023/A:1012534404328