{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:16:51Z","timestamp":1760059011049,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Bal\u00f3\u2019s concentric sclerosis stands out as a rare form of multiple sclerosis that features large tumor-like demyelinating lesions, which resemble brain tumors and create significant diagnostic and therapeutic obstacles for pediatric patients. Case Presentations: We present two case studies of pediatric patients, aged 11 and 15, diagnosed with extensive cerebral tumefactive inflammatory lesions indicative of Balo\u2019s type multiple sclerosis (MS). Both cases highlight the unique challenges faced in the diagnosis and treatment of this rare form of MS, characterized by the presence of large, tumor-like lesions that can mimic primary brain tumors. We will explore the diagnostic complexities, including the need for advanced imaging techniques, MR (Magnetic Resonance) spectroscopy, along with the time needed for differential diagnoses, which might delay the start of proper treatment. Current therapies, such as corticosteroids and immunomodulators, require customization to individual patients, carefully monitoring of clinical outcomes and possible side effects. This paper emphasizes that handling these cases requires a multidisciplinary approach, addressing not only the medical treatment but also the psychosocial needs of affected children and their families. By sharing these experiences, we aim to increase awareness about Balo\u2019s type MS in pediatric populations and provide clinical insights into effective management strategies for similar cases in clinical practice. Conclusions: Timely detection of atypical demyelinating lesions together with immediate treatment intervention plays a crucial role in pediatric Bal\u00f3-type MS. These cases demonstrate the essential role of advanced imaging and immunological testing in precise diagnosis while showcasing successful treatment approaches through corticosteroids and second-line immunotherapies, which improve patient outcomes in this atypical MS variant.<\/jats:p>","DOI":"10.3390\/children12050630","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T10:27:41Z","timestamp":1747218461000},"page":"630","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Overtime Challenges of Diagnosis and Treatment in Two Pediatric Patients with Extensive Cerebral Tumefactive Lesions Indicative of Bal\u00f3\u2019s Type Multiple Sclerosis"],"prefix":"10.3390","volume":"12","author":[{"given":"Alice Denisa","family":"Dic\u0103","sequence":"first","affiliation":[{"name":"\u201cProf. Dr. Alexandru Obregia\u201d Clinical Hospital of Psychiatry, 041914 Bucharest, Romania"},{"name":"Department of Pediatric Neurology, The Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Craiu","sequence":"additional","affiliation":[{"name":"\u201cProf. Dr. Alexandru Obregia\u201d Clinical Hospital of Psychiatry, 041914 Bucharest, Romania"},{"name":"Department of Pediatric Neurology, The Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catrinel","family":"Iliescu","sequence":"additional","affiliation":[{"name":"\u201cProf. Dr. Alexandru Obregia\u201d Clinical Hospital of Psychiatry, 041914 Bucharest, Romania"},{"name":"Department of Pediatric Neurology, The Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0533-9014","authenticated-orcid":false,"given":"Marcel-Alexandru","family":"G\u0103in\u0103","sequence":"additional","affiliation":[{"name":"3rd Medical Department, Psychiatry, The Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, University Street Nr. 10, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Sandu","sequence":"additional","affiliation":[{"name":"\u201cProf. Dr. Alexandru Obregia\u201d Clinical Hospital of Psychiatry, 041914 Bucharest, Romania"},{"name":"Department of Pediatric Neurology, The Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Pomeran","sequence":"additional","affiliation":[{"name":"\u201cProf. Dr. Alexandru Obregia\u201d Clinical Hospital of Psychiatry, 041914 Bucharest, Romania"},{"name":"Department of Pediatric Neurology, The Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Burloiu","sequence":"additional","affiliation":[{"name":"\u201cProf. Dr. Alexandru Obregia\u201d Clinical Hospital of Psychiatry, 041914 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8374-4255","authenticated-orcid":false,"given":"Alexandra-Maria","family":"G\u0103in\u0103","sequence":"additional","affiliation":[{"name":"3rd Medical Department, Psychiatry, The Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, University Street Nr. 10, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela Adriana","family":"Ion","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, The Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Pathophysiology, National Institute for Infectious Diseases \u201cProf. Dr. Matei Bal\u0219\u201c, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fisher, K.S., Cuascut, F.X., Rivera, V.M., and Hutton, G.J. (2020). Current Advances in Pediatric Onset Multiple Sclerosis. 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