Brain Tumor Res Treat.  2021 Apr;9(1):35-39. 10.14791/btrt.2021.9.e1.

Neuromyelitis Optica Spectrum Disorders Mimicking Multiple Brain Tumors

• Park SH
• Hwang JH

• KMID: 2515081
• DOI: http://doi.org/10.14791/btrt.2021.9.e1

Abstract

We report a rare case of neuromyelitis optica spectrum disorders (NMOSD), mimicking multiple brain tumors. A 53-year-old woman presented with weakness and paresthesia in her right arm and leg. Upon admission, brain MRI showed about 10 multiple brain tumors, which had to be differentiated from multiple brain metastases, lymphoma, and high-grade glioma in both hemispheres. No primary cancer was found in the chest-abdomen-pelvis CT. Subsequent spine MRI revealed multifocal cord signal change involving C2-T7, suggesting myelitis. A decrease in visual acuity was noted when taking a medical history, and optic neuritis was diagnosed upon ophthalmologic examination. With clinical and radiological appearances, multiple brain and spinal cord lesions have been diagnosed as NMOSD. Steroid and immunosuppressive drugs were administered. We should consider the possibility of an autoimmune disease, such as NMOSD, involving the optic nerve, spinal cord, and central nervous system when multiple hemispheric tumefactive lesions are observed.

Keyword

Neuromyelitis optica spectrum disorders; Optic neuritis; Spinal cord; Tumor.

Figure

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  Fig. 1 Brain MR images (A-C) show multiple enhancing masses in the right parahippocampal gyrus, occipitotemporal area, and left frontal lobe, which are considered multiple brain tumors. Nonspecific small dots and patches in the subcortical and white matter (D) are also seen.

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  Fig. 2 Cervical spine MRI shows multiple abnormal signal changes in the spinal cord over C2–T7, which is similar to acute myelitis.

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  Fig. 3 A 2-year follow-up brain MRI reveals the disappearance of enhanced lesions (A), but T2 high signal lesions are still observed (B).

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