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        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The concurrence of multiple sclerosis &#40;MS&#41; and glioma is uncommon&#46; Approximately 30 cases have been reported&#44; but in only six of them the tumour was pure or mixed oligodendroglioma&#46; The appearance of new neurological symptoms and signs in a patient with multiple sclerosis is usually attributed to a relapse of this disease and neuroradiological studies are not always performed&#46; When done&#44; the flnding of a new focal mass lesion is usually interpreted as a pseudotumoural plaque&#46;</p> <span class="elsevierStyleSectionTitle">Case Report</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A 37-year-old man was admitted because of partial simple seizures and an enlarging intracranial mass&#46; He had been diagnosed of MS eleven years earlier&#46; A MRI study performed eight years before admission showed a large mass in the right frontal lobe which was thought to be a pseudotumoural plaque&#46; Two years later&#44; he developed simple partial motor seizures that were initially controlled with valproic acid&#46; He remained well until three months before admission&#44; when seizures reappeared with a poor response to valproic acid&#46; A new MRI study showed an heterogeneus right frontal enlarging mass lesion&#46; A primary neoplasm was suspected and a subtotal removal was performed&#46; The pathological diagnosis was oligodendroglioma with a periferic demielinating area&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Atypical MRI lesions in a patient with MS must be carefully interpreted&#46; Pseudotumoural plaques have been described both clinically and radiologically to be hardly distinguishable from a tumoural lesion and histological confirmation is often required&#46; The association between MS and glioma is uncommon but it must be kept in mind when a mass lesion develops in a patient with MS&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La coexistencia de esclerosis m&#250;ltiple &#40;EM&#41; y glioma es un hecho infrecuente&#46; Se han descrito unos 30 casos de esta rara asociaci&#243;n&#44; pero en s&#243;lo seis de ellos el tumor fue un oligodendroglioma u oligoastrocitoma&#46; La aparici&#243;n de nuevos s&#237;ntomas neurol&#243;gicos en un paciente con EM es atribuida habi-tualmente a un nuevo brote de la enfermedad sin que se realicen nuevos estudios de imagen en la mayor&#237;a de los casos&#46; El hallazgo de una lesi&#243;n focal con efecto masa en un paciente con EM suele ser interpretada como una placa pseudotumoral&#46;</p> <span class="elsevierStyleSectionTitle">Caso cl&#237;nico</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de un var&#243;n de 37 a&#241;os con una historia de EM de 11 a&#241;os de evoluci&#243;n que presenta crisis parciales simples de nueva aparici&#243;n y una lesi&#243;n expansiva frontal derecha&#46; En una RM cerebral realizada 8 a&#241;os antes&#44; ya presentaba una lesi&#243;n frontal derecha con discreto efecto de masa que se interpret&#243; como una placa pseudotumoral&#46; Desde hace dos a&#241;os el paciente comenz&#243; a presentar crisis parciales motoras que respondieron inicialmente a tratamiento con &#225;cido valpr&#243;ico pero cada vez se fueron haciendo m&#225;s refractarias al tratamiento&#46; Un nuevo estudio de RM demostr&#243; una lesi&#243;n expansiva frontal derecha que hab&#237;a aumentado considerablemente de tama&#241;o con respecto a la RM previa&#46; Ante la sospecha de una lesi&#243;n tumoral primaria&#44; se opt&#243; por el tratamiento quir&#250;rgico&#44; realiz&#225;ndose una resecci&#243;n subtotal&#46; El diagn&#243;stico anatomopatol&#243;gico fue de oligodendroglioma con &#225;reas perif&#233;ricas de desmielinizaci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En los pacientes con EM&#44; la aparici&#243;n de una lesi&#243;n at&#237;pica en la RM debe ser interpretada con cautela&#46; Las placas pseudotumorales son muchas veces indistinguibles desde el punto de vista cl&#237;nico y radiol&#243;gico de las lesiones tumorales y frecuentemente se requiere una confirmaci&#243;n histol&#243;gica&#46; La asociaci&#243;n entre EM y glioma es infrecuente&#44; pero debe ser tenida en cuenta cuando aparece una lesi&#243;n focal con efecto masa en un paciente con EM&#46;</p>"
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Vol. 15. Núm. 4.
Páginas 378-383 (enero 2004)
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Vol. 15. Núm. 4.
Páginas 378-383 (enero 2004)
Oligodendroglioma and multiple sclerosis. A case report
Oligodendroglioma y esclerosis multiple: a propósito de un caso
Visitas
1722
A. de la Lama
, P.A. Gómez, G.R. Boto, A. Lagares, J.F. Alen, R.D. Lobato
Department of Neurosurgery. Hospital Doce de Octubre. Madrid. Spain
J.R. Ricoy*
* Neuropathology. Hospital Doce de Octubre. Madrid. Spain
Este artículo ha recibido
Información del artículo
Summary
Background

The concurrence of multiple sclerosis (MS) and glioma is uncommon. Approximately 30 cases have been reported, but in only six of them the tumour was pure or mixed oligodendroglioma. The appearance of new neurological symptoms and signs in a patient with multiple sclerosis is usually attributed to a relapse of this disease and neuroradiological studies are not always performed. When done, the flnding of a new focal mass lesion is usually interpreted as a pseudotumoural plaque.

Case Report

A 37-year-old man was admitted because of partial simple seizures and an enlarging intracranial mass. He had been diagnosed of MS eleven years earlier. A MRI study performed eight years before admission showed a large mass in the right frontal lobe which was thought to be a pseudotumoural plaque. Two years later, he developed simple partial motor seizures that were initially controlled with valproic acid. He remained well until three months before admission, when seizures reappeared with a poor response to valproic acid. A new MRI study showed an heterogeneus right frontal enlarging mass lesion. A primary neoplasm was suspected and a subtotal removal was performed. The pathological diagnosis was oligodendroglioma with a periferic demielinating area.

Conclusion

Atypical MRI lesions in a patient with MS must be carefully interpreted. Pseudotumoural plaques have been described both clinically and radiologically to be hardly distinguishable from a tumoural lesion and histological confirmation is often required. The association between MS and glioma is uncommon but it must be kept in mind when a mass lesion develops in a patient with MS.

Key words:
Multiple sclerosis
Glioma
Oligodendroglioma
Brain tumour
Abreviaturas:
EM
MS
Resumen
Introducción

La coexistencia de esclerosis múltiple (EM) y glioma es un hecho infrecuente. Se han descrito unos 30 casos de esta rara asociación, pero en sólo seis de ellos el tumor fue un oligodendroglioma u oligoastrocitoma. La aparición de nuevos síntomas neurológicos en un paciente con EM es atribuida habi-tualmente a un nuevo brote de la enfermedad sin que se realicen nuevos estudios de imagen en la mayoría de los casos. El hallazgo de una lesión focal con efecto masa en un paciente con EM suele ser interpretada como una placa pseudotumoral.

Caso clínico

Presentamos el caso de un varón de 37 años con una historia de EM de 11 años de evolución que presenta crisis parciales simples de nueva aparición y una lesión expansiva frontal derecha. En una RM cerebral realizada 8 años antes, ya presentaba una lesión frontal derecha con discreto efecto de masa que se interpretó como una placa pseudotumoral. Desde hace dos años el paciente comenzó a presentar crisis parciales motoras que respondieron inicialmente a tratamiento con ácido valpróico pero cada vez se fueron haciendo más refractarias al tratamiento. Un nuevo estudio de RM demostró una lesión expansiva frontal derecha que había aumentado considerablemente de tamaño con respecto a la RM previa. Ante la sospecha de una lesión tumoral primaria, se optó por el tratamiento quirúrgico, realizándose una resección subtotal. El diagnóstico anatomopatológico fue de oligodendroglioma con áreas periféricas de desmielinización.

Conclusión

En los pacientes con EM, la aparición de una lesión atípica en la RM debe ser interpretada con cautela. Las placas pseudotumorales son muchas veces indistinguibles desde el punto de vista clínico y radiológico de las lesiones tumorales y frecuentemente se requiere una confirmación histológica. La asociación entre EM y glioma es infrecuente, pero debe ser tenida en cuenta cuando aparece una lesión focal con efecto masa en un paciente con EM.

Palabras clave:
Esclerosis múltiple
Glioma
Oligodendroglioma
Tumor cerebral

Artículo

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