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Tumefactive Demyelinating Lesions (TDL)


Definition

  • Acute, inflammatory demyelinating disease, which presents as a solitary, large (>2 cm) focus of demyelination within a cerebral hemisphere with associated edema that may simulate neoplasm or abscess; synonyms include tumefactive multiple sclerosis lesions, tumor-like demyelinating lesions, and demyelinating pseudotumors

Clinical Features

Epidemiology

  • Rare (but must be distinguished from tumor because of marked differences in therapy)

  • Affects all ages; range 2 to 71 years old (average age, 37)

  • Female predominance

  • Proposed etiologies of TDL: part of the spectrum of multiple sclerosis (MS), autoimmune disease associated with antecedent infection or vaccination

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