Lesiones pseudotumorales como forma de presentación de la esclerosis múltiple: investigación dirigida a su significado pronóstico ; Pseudotumoral lesions as a presentation form in multiple sclerosis: research into its prognostic meaning

Pseudotumoral lesions are considered an atypical manifestation of demyelination of the central nervous system. Due to their scarce frequency in patients with multiple sclerosis (MS), they usually constitute a diagnostic challenge. Our aim wasto study the characteristics of patients with pseudotumoral lesions in a first clinical episode, contributing to the description of this form of MS and its prognostic implication. Patients with pseudotumoral forms of MS were identified in the database of the monographic outpatient clinic of the Marqués de Valdecilla University Hospital; and demographic, clinical, analytical and radiological (MRI) variables were analysed retrospectively in patients with these lesions. Of the 450 patients included in the database, 14 (57% male) with a mean age of 33.64 years, presented with pseudotumoral lesions. The most frequent form of presentation was motor (71%) or sensory (71%) deficits, followed by cerebellar or brainstem symptoms. The majority (85%) required hospitalization, although only 3 cases required diagnostic biopsy. The most frequent location for lesions was periventricular. At follow up, 11 patients (78%) met RRMS criteria and 3 met CIS criteria (21%). In addition, 10 patients started disease-modifying treatment. Our results are in line with previous studies, providing further information on the particularities of these lesions, both clinically and radiologically. Future research is needed to better understand both this form of MS and its prognostic significance. ; RESUMEN : Las lesiones pseudotumorales se consideran una manifestación atípica de la desmielinización del sistema nervioso central. Su escasa frecuencia en pacientes con esclerosis múltiple (EM) constituye habitualmente un reto diagnóstico. Nuestro objetivo es estudiar las características de los pacientes con dichas lesiones en un primer episodio clínico, contribuyendo a la descripción de esta forma de EM y su implicación pronóstica. Se identificaron pacientes con formas pseudotumorales de EM en la base ...