{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:21:17Z","timestamp":1761920477069,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,6,8]]},"abstract":"<jats:p>Tumefactive appearing lesions on brain imaging can cause a diagnostic dilemma. We report a middle-aged man who presented with right-sided optic neuritis. A brain MRI showed enhancement of the right optic nerve, and non-enhancing white matter lesions including a 3 cm right frontal lesion with adjacent gyral expansion. Cerebrospinal fluid analysis showed five oligoclonal bands not present in serum. Glatiramer acetate was started for suspected tumefactive multiple sclerosis (MS). A follow-up brain MRI 6\u2009months later showed persistence of the frontal gyral expansion. A brain biopsy led to the diagnosis of an oligodendroglioma, isocitrate dehydrogenase-mutant and 1\u2009p\/19q co-deleted (WHO grade II), managed with surgical resection and radiotherapy. Postoperative brain MRI showed a new enhancing periventricular lesion, making the choice of optimal disease-modifying therapy for MS challenging. This case highlights the possibility of coexistence of MS and oligodendroglioma, and emphasises the importance of a tissue diagnosis when atypical MS imaging features are present.<\/jats:p>","DOI":"10.1136\/bcr-2018-225318","type":"journal-article","created":{"date-parts":[[2018,6,28]],"date-time":"2018-06-28T10:08:36Z","timestamp":1530180516000},"page":"bcr-2018-225318","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["A case of oligodendroglioma and multiple sclerosis: Occam\u2019s razor or Hickam\u2019s dictum?"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8866-6426","authenticated-orcid":false,"given":"Afsaneh","family":"Shirani","sequence":"first","affiliation":[{"name":"Department of Neurology, Washington University in Saint Louis School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory F.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Washington University in Saint Louis School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Giannini","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne H.","family":"Cross","sequence":"additional","affiliation":[{"name":"Department of Neurology, Washington University in Saint Louis School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,28]]},"reference":[{"key":"2025082702182217000_2018.jun28_1.bcr-2018-225318.1","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.msard.2015.07.013","article-title":"Neuro-oncology dilemma: tumour or tumefactive demyelinating lesion","volume":"4","author":"Abdoli","year":"2015","journal-title":"Mult Scler Relat Disord"},{"doi-asserted-by":"publisher","key":"2025082702182217000_2018.jun28_1.bcr-2018-225318.2","DOI":"10.1007\/s00401-015-1424-1"},{"doi-asserted-by":"publisher","key":"2025082702182217000_2018.jun28_1.bcr-2018-225318.3","DOI":"10.1259\/bjr.20150857"},{"key":"2025082702182217000_2018.jun28_1.bcr-2018-225318.4","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1053\/j.seminoncol.2014.06.009","article-title":"Oligodendroglial tumors","volume":"41","author":"Jaeckle","year":"2014","journal-title":"Semin Oncol"},{"doi-asserted-by":"publisher","key":"2025082702182217000_2018.jun28_1.bcr-2018-225318.5","DOI":"10.1136\/jnnp-2012-304498"},{"doi-asserted-by":"publisher","key":"2025082702182217000_2018.jun28_1.bcr-2018-225318.6","DOI":"10.1093\/brain\/awn098"},{"doi-asserted-by":"publisher","key":"2025082702182217000_2018.jun28_1.bcr-2018-225318.7","DOI":"10.1177\/135245850100700410"},{"key":"2025082702182217000_2018.jun28_1.bcr-2018-225318.8","first-page":"1","article-title":"Multiple sclerosis and oligodendroglioma: an exceptional association","volume":"2014","author":"Carvalho","year":"2014","journal-title":"Case Rep Neurol Med"},{"key":"2025082702182217000_2018.jun28_1.bcr-2018-225318.9","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/S1130-1473(04)70473-X","article-title":"Oligodendroglioma and multiple sclerosis. 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