Multiple Sclerosis and Glioblastoma: a Diagnostic-Therapeutic Challenge

Background: Multiple Sclerosis (MS) is a demyelinating neurodegenerative disease of the CNS on an autoimmune basis, whose lesions involve the white matter. MS patients can develop spaceoccupying lesions that can be mistaken for neoplasm, and this form of MS is termed Tumefactive MS, but in rare cases, however, there may be a coincidence of MS and CNS neoplasm in the same patient. Case History: A woman with MS for sudden onset of right hemiplegia and dysarthria underwent brain MRI with contrast medium with evidence of a primary cerebral neoplasm of the glial series, infiltrating, multifocal and high grade. Stereotactic brain biopsy confirmed the diagnosis of glioblastoma multiforme. The patient, due to the symptoms, the volume and multifocality of the disease was a candidate for hypofractionated whole brain radiotherapy. Discussion: The occasional development of gliomas in MS cases is well known, but the number of reported cases is still small. Our case emphasizes the importance of considering brain tumors in the differential diagnosis of primary demyelinating disease presenting with a cerebral mass lesion and reiterates the need to carefully evaluate symptoms and brain MRI, even in welldocumented individuals with MS. References 1. Abrishamchi F,Khorvash F (2017) Coexistence of Multiple Sclerosis and Brain Tumor: An Uncommon Diagnostic Challenge. Adv Biomed Res 6: 101. 2. Frederick MC, Cameron MH (2016) Tumefactive Demyelinating Lesions in Multiple Sclerosis and Associated Disorders, Curr Neurol Neurosci Rep 16: 26.

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