AUTHOR=Petrášová Martina , Šrotová Iva , Kolčava Jan , Štourač Pavel , Hynková Ludmila , Keřkovský Miloš , Pikulová Hana , Neuman Eduard , Kren Leoš , Vlčková Eva 

TITLE=Case report: Diagnostic challenge: a new multiple sclerosis “relapse” leading to the diagnosis of anaplastic astrocytoma

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1324269

DOI=10.3389/fneur.2023.1324269

ISSN=1664-2295

ABSTRACT=Cerebral tumors and multiple sclerosis (MS) can show overlapping clinical and magnetic resonance imaging (MRI) features and even occur concurrently. Due to the emergence of new symptoms, not usually MS related, an MRI was conductedA routine follow-up MRI in a 29-year-old woman with relapsing-remitting multiple sclerosisMS and showed a significant size progression of a parietooccipital lesion, with mild clinical correlates, such as blurred vision, difficulty in speaking, and, headache. We performed a cContrast-enhanced MRI and fluorothymidine positron-emission tomography (PET) and they both did not point towards neoplasm, but a lesion biopsy, however, showed astrocytoma, which was confirmed as grade III astrocytoma after the. R radical resection of the tumor followed with post-operative histopathology confirming grade III astrocytoma. In the case of an atypical lesion, a tumor should be considered in patients with multiple MSsclerosis. A small fraction of high-grade gliomas shows no enhancement on MRI and no hypermetabolism on PET. Biopsy proved to be the essential step in a successful diagnostic workup. To the best of our knowledge, this is the first case of anaplastic astrocytoma with these radiological features reported in a patient with MSmultiple sclerosis.