Open-Ring Enhancement in Pseudotumoral Multiple Sclerosis: Important Radiological Aspect

Introduction. Observation of open-ring enhancement in magnetic resonance imaging (MRI) is considered a specificity marker for diagnosing pseudotumoral multiple sclerosis (MS). This finding is of great value in the differential diagnosis of tumefactive lesions. Case Report. We describe a 55-year-old...

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Bibliographic Details
Main Authors: Frederico Carvalho de Medeiros, Lucas Alverne Freitas de Albuquerque, Jose Eymard Homem Pittella, Renata Brant de Souza, Antonio Pereira Gomes Neto, Paulo Pereira Christo
Format: Article
Language:English
Published: Hindawi Limited 2014-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2014/951690
Description
Summary:Introduction. Observation of open-ring enhancement in magnetic resonance imaging (MRI) is considered a specificity marker for diagnosing pseudotumoral multiple sclerosis (MS). This finding is of great value in the differential diagnosis of tumefactive lesions. Case Report. We describe a 55-year-old white woman, with previous history of ovarian cancer and recent history of fatigue and bilateral retroorbital pain. Important bilateral visual impairment evolved over one month. Physical examination detected the presence of right homonymous hemianopia. Cranial MRI showed an expanding lesion with open-ring enhancement. Given the range of diagnostic possibilities, a stereotactic biopsy was performed, and histopathological examination was consistent with an active demyelinating disease. The patient was treated with 1 g of methylprednisolone and symptoms improved following a significant reduction in the lesion. Conclusions. We highlight the MRI results suggestive of pseudotumoral MS, especially open-ring enhancement, which is an important radiologic aspect to diagnosis and can assist in avoiding unnecessary biopsies.
ISSN:2090-6668
2090-6676