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Tumefactive demyelinating disease mimicking malignant tumor in positron emission tomography with 11 C‐methionine
Author(s) -
Matsuzono Kosuke,
Deguchi Kentaro,
Hishikawa Nozomi,
Yamashita Toru,
Ichikawa Tomotsugu,
Date Isao,
Abe Koji
Publication year - 2015
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.150
Subject(s) - medicine , positron emission tomography , lesion , magnetic resonance imaging , radiology , methionine , fluorodeoxyglucose , stereotactic biopsy , brain biopsy , biopsy , pathology , frontal lobe , nuclear medicine , amino acid , biochemistry , chemistry , psychiatry
Tumefactive demyelination is sometimes difficult differentiate from malignant tumors. Positron emission tomography with 11 C‐methionine is useful for diagnosing cerebral malignant tumors, but there are previous reports for tumefactive demyelination. We experienced a 32‐year‐old man who suffered from subacute onset dysarthria and left hemiparesis with magnetic resonance image of a large lesion (5.3 × 4.2 cm) in the right frontal lobe. Positron emission tomography with 18 F‐fluorodeoxyglucose showed a high ring‐shaped glucose uptake in the lesion and 11 C‐methionine showed a remarkable methionine uptake in the whole lesion. Although a malignant tumor was suspected, the patient was finally diagnosed with tumefactive demyelinating disease based on brain biopsy results, and was treated completely by methylpredonisolone therapy. Although 11 C‐methionine uptake with positron emission tomography commonly suggests a malignant tumor, there can still be a possibility of tumefactive demyelinating disease.