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Neurol."],"abstract":"<jats:p>Tumefactive demyelinating lesions belong to the rare variants of multiple sclerosis, posing a diagnostic challenge since it is difficult to distinguish them from a neoplasm or other brain lesions and they require a careful differential diagnosis. This contribution presents the case report of a young female with progressive tumefactive demyelinating brain and spinal cord lesions. An extensive diagnostic process including two brain biopsies and an autopsy did not reveal any explanatory diagnosis other than multiple sclerosis. The patient was treated by various disease-modifying treatments without significant effect and died from ascendent infection via ventriculoperitoneal shunt resulting in <jats:italic>Staphylococcus aureus<\/jats:italic> meningitis.<\/jats:p>","DOI":"10.3389\/fneur.2021.701663","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T09:38:01Z","timestamp":1625737081000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Progressive Tumefactive Demyelination as the Only Result of Extensive Diagnostic Work-Up: A Case Report"],"prefix":"10.3389","volume":"12","author":[{"given":"Pavel","family":"\u0160toura\u010d","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Kol\u010dava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milo\u0161","family":"Ke\u0159kovsk\u00fd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tereza","family":"Kop\u0159ivov\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo\u0161","family":"K\u0159en","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josef","family":"Bedna\u0159\u00edk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1093\/brain\/awn098","article-title":"Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis","volume":"131","author":"Lucchinetti","year":"2008","journal-title":"Brain."},{"key":"B2","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1007\/s11910-016-0626-9","article-title":"Tumefactive demyelinating lesions in multiple sclerosis and associated disorders","volume":"16","author":"Frederick","year":"2016","journal-title":"Curr Neurol Neurosci Rep."},{"key":"B3","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.jns.2017.08.005","article-title":"Tumefactive demyelinating lesions of 15 patients: clinico-radiological features, management and review of the literature","volume":"381","author":"S\u00e1nchez","year":"2017","journal-title":"J Neurol Sci."},{"key":"B4","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.msard.2017.04.003","article-title":"Tumefactive demyelinating lesions: a comprehensive review","volume":"14","author":"Algahtani","year":"2017","journal-title":"Mult Scler Relat Disord."},{"key":"B5","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1002\/ana.22366","article-title":"Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria","volume":"69","author":"Polman","year":"2011","journal-title":"Ann Neurol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"195","DOI":"10.2214\/ajr.182.1.1820195","article-title":"The MRI appearance of tumefactive demyelinating lesions","volume":"182","author":"Given","year":"2004","journal-title":"Am J Roentgenol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s12883-016-0596-1","article-title":"Demyelination as a harbinger of lymphoma: a case report and review of primary central nervous system lymphoma preceded by multifocal sentinel demyelination","volume":"16","author":"Kvarta","year":"2016","journal-title":"BMC Neurol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.3174\/ajnr.A5775","article-title":"MRI findings in tumefactive demyelinating lesions: a systematic review and meta-analysis","volume":"39","author":"Suh","year":"2018","journal-title":"Am J Neuroradiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"176","DOI":"10.2176\/nmc.oa.2018-0287","article-title":"Usefulness of [11C] methionine PET in the differentiation of tumefactive multiple sclerosis from high grade astrocytoma","volume":"59","author":"Hashimoto","year":"2019","journal-title":"Neurol Med Chir."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e342","DOI":"10.1097\/RLU.0000000000001229","article-title":"FLT PET\/CT in a case of demyelinating disease","volume":"41","author":"Nikaki","year":"2016","journal-title":"Clin Nucl Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.jns.2012.10.026","article-title":"Benign course of tumour-like multiple sclerosis. 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