LESIÓN TUMEFACTA DESMIELINIZANTE: REVISIÓN BIBLIOGRÁFICA

Autores/as

  • Miguel Angel Esquivel Miranda CCSS/UCR/PINECOS
  • Jordan Arriola Gutiérrez

Palabras clave:

Glioma, Esclerosis Múltiple, Linfoma, Desmielinizante

Resumen

Resumen

            La lesión tumefacta desmielinizante es una variedad rara de la esclerosis múltiple, cuya fisiopatología no ha sido dilucidada. Son lesiones poco frecuentes, con una prevalencia cercana a los 0.3 casos por 100.000 habitantes. Su clínica corresponde a la de una lesión espacio ocupante cerebral de aspecto tumoral, y a pesar de considerarse una variante de la Esclerosis Múltiple (EM), no traduce la sintomatología típica de la misma. Por las razones anteriores, constituye un reto diagnóstico y terapéutico dada su similitud con patologías neoplásicas de sistema nervioso central, especialmente el glioma. Con el presente trabajo se pretende hacer una revisión de esta patología y ofrecer una herramienta para el diagnóstico, haciendo hincapié en las herramientas imagenológicas a fin de favorecer el tratamiento y minimizar en lo posible procedimientos invasivos.

Abstract

The Tumefactive Demyelinating Lesion (TDL) is a rare variety of Multiple Sclerosis (MS), whose physiopathology has not been yet dilucidated. Its prevalence is close to 0.3 per 100.000 habitants. Its clinical presentation is that of a space occupying lesion, and despite being a variety of MS, it doesn´t manifest the typical symptomatology.  Given these reasons, it constitutes a diagnostic and therapeutic challenge, since it easily resembles central nervous system neoplastic pathologies, for example, gliomas. In this paper we aim to deliver a diagnostic and therapeutic tool, highlighting the process based in imagenologic devices to avoid unnecessary invasive procedures.

Resumo

A lesão inchada desmielinizante e uma variante esquisita da Esclerose Múltipla, cuja fisiopatologia não foi elucidada ainda. A sua prevalência está perto de 0.3/100.000 habitantes. Sua manifestação clínica e duma lesão espaço ocupante, e ainda sendo variante da MS, não presenta seus sintomas clássicos. E por isto, que o diagnóstico e o tratamento e um reto, especialmente porque simula patologias neoplásicas do Sistema nervosa central como o glioma. Neste artigo, tentamos fazer uma ferramenta diagnostica e terapêutica, sublinhando a utilização de técnicas de imagens para evitar os procedimentos invasivos.   

Citas

Abdoli, M., Freedman, M.S., 2015. Neuro-oncology dilemma: Tumour or

tumefactive demyelinating lesion. Mult Scler Relat Disord 4, 555–566.

https://doi.org/10.1016/j.msard.2015.07.013

Algahtani, H., Shirah, B., Alassiri, A., 2017. Tumefactive demyelinating lesions: A

comprehensive review. Mult Scler Relat Disord 14, 72–79.

https://doi.org/10.1016/j.msard.2017.04.003

Barbosa, B.C., Marchiori, E., Leal Leidersnaider, C., Brandao, L., Castillo, M., 2019.

Demyelinating lesions behaving like aggressive tumours on advanced MRI

techniques. Neuroradiol J 32, 103–107.

https://doi.org/10.1177/1971400919826394

Butteriss, D.J.A., Ismail, A., Ellison, D.W., Birchall, D., 2003. Use of serial proton

magnetic resonance spectroscopy to differentiate low grade glioma from

tumefactive plaque in a patient with multiple sclerosis. Br J Radiol 76, 662–

https://doi.org/10.1259/bjr/85069069

Chiavazza, C., Pellerino, A., Ferrio, F., Cistaro, A., Soffietti, R., Rudà, R., 2018.

Primary CNS Lymphomas: Challenges in Diagnosis and Monitoring.

Biomed Res Int 2018, 3606970. https://doi.org/10.1155/2018/3606970

Dobson, R., Giovannoni, G., 2019. Multiple sclerosis - a review. Eur J Neurol 26,

–40. https://doi.org/10.1111/ene.13819

Fan, X., Mahta, A., De Jager, P.L., Kesari, S., 2012. Rituximab for tumefactive

inflammatory demyelination: a case report. Clin Neurol Neurosurg 114,

–1328. https://doi.org/10.1016/j.clineuro.2012.03.010

Frederick, M.C., Cameron, M.H., 2016. Tumefactive Demyelinating Lesions in

Multiple Sclerosis and Associated Disorders. Curr Neurol Neurosci Rep 16,

https://doi.org/10.1007/s11910-016-0626-9

Hardy, T.A., Chataway, J., 2013. Tumefactive demyelination: an approach to

diagnosis and management. J Neurol Neurosurg Psychiatry 84, 1047–

https://doi.org/10.1136/jnnp-2012-304498

Ikeguchi, R., Shimizu, Y., Abe, Kayoko, Shimizu, S., Maruyama, T., Nitta, M., Abe,

Koichiro, Kawamata, T., Kitagawa, K., 2018. Proton magnetic resonance

spectroscopy differentiates tumefactive demyelinating lesions fromNeurociencias Journal Vol 28Núm 3 Esquivel M y Arriola J.

Página | 111

gliomas. Mult Scler Relat Disord 26, 77–84.

https://doi.org/10.1016/j.msard.2018.08.025

Jain, R.S., Khan, I., Kandelwal, K., Desai, T., 2017. Tumefactive demyelinating

lesions (TDLs): A case series of clinicoradiological features. Clin Neurol

Neurosurg 162, 91–94. https://doi.org/10.1016/j.clineuro.2017.09.013

Kepes, J.J., 1993. Large focal tumor-like demyelinating lesions of the brain:

intermediate entity between multiple sclerosis and acute disseminated

encephalomyelitis? A study of 31 patients. Ann Neurol 33, 18–27.

https://doi.org/10.1002/ana.410330105

Kim, D.S., Na, D.G., Kim, K.H., Kim, J.-H., Kim, E., Yun, B.L., Chang, K.-H., 2009.

Distinguishing tumefactive demyelinating lesions from glioma or central

nervous system lymphoma: added value of unenhanced CT compared

with conventional contrast-enhanced MR imaging. Radiology 251, 467–

https://doi.org/10.1148/radiol.2512072071

La Mantia, L., Tramacere, I., Firwana, B., Pacchetti, I., Palumbo, R., Filippini, G.,

Fingolimod for relapsing-remitting multiple sclerosis. Cochrane

Database Syst Rev 4, CD009371.

https://doi.org/10.1002/14651858.CD009371.pub2

Mujic, A., Liddell, J., Hunn, A., McArdle, J., Beasley, A., 2002. Non-neoplastic

demyelinating process mimicking a disseminated malignant brain

tumour. J Clin Neurosci 9, 313–317.

https://doi.org/10.1054/jocn.2001.0961

Nayak, L., Reardon, D.A., 2017. High-grade Gliomas. CONTINUUM: Lifelong

Learning in Neurology 23, 1548.

https://doi.org/10.1212/CON.0000000000000554

Neuroimmunology Group of Neurology Branch of Chinese Medical Association,

Neuroimmunology Committee of Chinese Society for Immunology,

Immunology Society of Chinese Stroke Association, 2017. Chinese

Guidelines for the Diagnosis and Management of Tumefactive

Demyelinating Lesions of Central Nervous System. Chin Med J (Engl) 130,

–1850. https://doi.org/10.4103/0366-6999.211547

Pakos, E.E., Tsekeris, P.G., Chatzidimou, K., Goussia, A.C., Markoula, S.,

Argyropoulou, M.I., Pitouli, E.G., Konitsiotis, S., 2005. Astrocytoma-like

multiple sclerosis. Clin Neurol Neurosurg 107, 152–157.

https://doi.org/10.1016/j.clineuro.2004.06.003

POPE, W.B., BRANDAL, G., 2018. Conventional and advanced magnetic

resonance imaging in patients with high-grade glioma. Q J Nucl Med Mol

Imaging 62, 239–253. https://doi.org/10.23736/S1824-4785.18.03086-8Neurociencias Journal Vol 28Núm 3 Esquivel M y Arriola J.

Página | 112

QI, W., JIA, G., WANG, X., ZHANG, M., MA, Z., 2015. Cerebral tumefactive

demyelinating lesions. Oncol Lett 10, 1763–1768.

https://doi.org/10.3892/ol.2015.3481

Sánchez, P., Meca-Lallana, V., Barbosa, A., Manzanares, R., Palmí, I., Vivancos, J.,

Tumefactive demyelinating lesions of 15 patients: Clinicoradiological features, management and review of the literature. J Neurol

Sci 381, 32–38. https://doi.org/10.1016/j.jns.2017.08.005

Seifert, C.L., Wegner, C., Sprenger, T., Weber, M.S., Brück, W., Hemmer, B.,

Sellner, J., 2012. Favourable response to plasma exchange in tumefactive

CNS demyelination with delayed B-cell response. Mult Scler 18, 1045–

https://doi.org/10.1177/1352458511429012

Suh, C.H., Kim, H.S., Jung, S.C., Choi, C.G., Kim, S.J., 2018. MRI Findings in

Tumefactive Demyelinating Lesions: A Systematic Review and MetaAnalysis. AJNR Am J Neuroradiol 39, 1643–1649.

https://doi.org/10.3174/ajnr.A5775

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Publicado

2022-03-29

Cómo citar

Esquivel Miranda, M. A., & Arriola Gutiérrez, J. . (2022). LESIÓN TUMEFACTA DESMIELINIZANTE: REVISIÓN BIBLIOGRÁFICA. Neurociencias Journal, 28(3), 97–112. Recuperado a partir de https://www.neurocienciasjournal.com/index.php/neurocienciasjournal/article/view/182

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Artículo de revisión