Tumefactive Multiple Sclerosis

Multiple sclerosis, or MS, breaks down the fatty, protective layer that covers the nerves around your brain, spine, and eyes. It can damage the nerves and make it hard for your body to function the right way.

Tumefactive MS is a rare type that causes a tumor-like growth in the brain. Symptoms are similar to what happens with brain tumors. Over time, it usually turns into relapsing-remitting MS. That’s when you have an episode (a relapse), then get better (remit).

You can manage the disease, but it tends to get worse over time. Tumefactive MS can sometimes lead to fatal health conditions.

Symptoms

Symptoms of tumefactive multiple sclerosis are often different from the symptoms of general multiple sclerosis. You may have:

  • Confused thinking
  • Trouble talking or understanding others
  • Weakness
  • Seizures
  • Headaches

Causes

Scientists know your immune system attacks your body by mistake when you have MS. They also know your risk of getting MS goes up if one of your parents has it. But they’re not sure what causes general multiple sclerosis or the tumefactive form.

Diagnosis

The doctor will ask about your medical history and your most recent symptoms. They’ll do a special exam to see how your body responds to touch and visual signals, among other things.

Symptoms of tumefactive MS often look like those of other conditions, like brain tumors. That’s why your doctor has to make sure it’s not something else. They’ll order magnetic resonance imaging (MRI) scans of the spinal cord and brain to look for unusual growths. Your doctor may do one or more of these tests, too:

  • A spinal tap to remove spinal fluid for analysis
  • Single-photon emission computed tomography (SPECT)
  • MR spectroscopy
  • Nerve function tests
  • Blood tests

If they still can’t figure out what’s going on, the doctor will take out a small piece of the growth and look at it under a microscope. That’s called a biopsy. This type of biopsy can be risky because it’s in your brain.

Treatment

It’s rare, but you may not have any symptoms from tumefactive MS. In that case, your doctor might decide to wait and see what happens.

Usually, though, the growth causes symptoms because of its size. There’s no specific treatment for tumefactive MS. Your doctor may use corticosteroids, like methylprednisolone, to help ease inflammation.

If that doesn’t work, they might try to remove and replace part of your blood during a plasma exchange. It gets rid of proteins called autoantibodies that attack your immune system. Your doctor could also decide to try a medicine called rituximab, which targets your immune system. It’s often used to treat cancers like non-Hodgkin’s lymphoma and leukemia, among other diseases.

WebMD Medical Reference Reviewed by Christopher Melinosky on August 11, 2020

Sources

SOURCES:

British Journal of Medical Practitioners: “Tumefactive Multiple Sclerosis Masquerading as Cancer.”

Cedars-Sinai: “Tumefactive Multiple Sclerosis.”

Mayo Clinic: “Rituximab (Intravenous Route).”

National Organization for Rare Disorders: “Multiple Sclerosis.”

NIH Genetic and Rare Diseases Information Center: “Tumefactive multiple sclerosis.”

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