Clinical analysis of five cases of demyelinating pseudotumor

Abstract

Objective To study the clinical manifestations, imaging and pathological features, treatment and prognosis of 5 patients diagnosed as demyelinating pseudotumor (DPT) by pathology. Methods The data of clinical features, radiological and histological examination of 5 patients with DPT were retrospectively analyzed, and relevant literatures were reviewed.  Results All patients were male. Main symptoms included limb weakness in 3 cases, dizziness and impaired memory in 2 cases, seizures in one case. Head MRI examination revealed space-occupying lesions with hypointense signal on T₁WI, hyperintense signal on T₂WI and FLAIR. Enhanced MRI showed obvious enhancement of lesions (open-ring enhancement in 3 cases). The lesion were totally (4 cases) or partially (one case) removed, and postoperative histological examination showed inflammatory demyelination. One case died after twice relapse, and others had favorable prognosis.  Conclusions DPT is an inflammatory demyelination with mass effect. It should be differentiated from central nervous system tumors in order to avoid unnecessary resection or radiotherapy.

DOI: 10.3969/j.issn.1672-6731.2017.03.010