Tumefactive Multiple Sclerosis: Challenges With Treatment Modalities

Tumefactive multiple sclerosis comprises a rare subset of that often poses diagnostic challenge to physicians. It is unique in its presentation as solitary lesion, usually larger than 2 cm, with surrounding vasogenic edema, commonly mimicking primary intracranial malignancy. We present case 25-year-old female no significant past medical history who presented our institution homonymous superior quadrantanopia. During her admission, she underwent magnetic resonance imaging (MRI) the brain, which revealed large lesion left temporal area surrounded by marked edema. A thorough workup diagnosis tumefactive sclerosis. Subsequently, was initiated on intravenous immunoglobulin rather stress dose steroids, given concern for superimposed infection. Interestingly, patient had paradoxical progression symptoms well expansion edema repeat MRI. In case, we highlight key differences and management.