Case Report: Treatment-Refractory Tumefactive Multiple Sclerosis in a Human Subject
A 47-year-old woman with left facial numbness underwent a brain biopsy, which confirmed tumefactive multiple sclerosis (TMS). She was treated with IV methylprednisolone followed by oral prednisone, which led to clinical improvement. However, over two years, she had recurrent TMS flares and progressive disability despite being on disease-modifying therapy with ocrelizumab.
- Tags
- #MSResearch
- Most relevant to
- —
- Human efficacy
- Demonstrated in people
- Mechanism
- Not reported
- Evidence strength
- Limited
- Outcome
- Mixed
Why it matters
This case underscores the challenges in managing treatment-refractory MS and highlights the potential for progressive disability despite therapy. It also suggests a need for alternative strategies in refractory cases, like considering natalizumab, though more evidence is necessary.
What this does not prove
The findings are based on a single patient case, limiting generalizability to the wider population of TMS patients.
Next milestone
No next milestone was established from the available source.
Study facts
- Study design
- Case report
- Participants / samples
- Not reported
- Randomised
- Not reported
- Controlled
- Not reported
- Primary endpoint met
- Not reported
- Relevant MS type
- Not reported
- Publication date
- 2026-10-30
- Evidence reviewed
- Abstract only
- Regulatory approval
- Not reported
- Research areas
- Not classified
- Biological target
- Not reported
- Pathway
- Not reported
- Population
- Not reported
- Size of effect
- Not reported
- Secondary endpoints
- Not reported
- MRI endpoints
- Not reported
- Biomarkers
- Not reported
- Safety
- Not reported
Original sources
- Primary evidenceA Case of Treatment-Refractory Tumefactive Multiple Sclerosis Mimicking Brain Abscess. ↗DOI: 10.1155/crnm/1858367
Supporting passages (9)
study designPublication types: Journal Article
subjectsA 47-year-old female presented with one week of left facial numbness following recent dental extractions.
interventionFollowing the brain biopsy, the patient received five days of IV methylprednisolone 1 g daily, followed by a two-week oral prednisone taper with clinical improvement.
findingsBrain biopsy subsequently demonstrated macrophages, reactive lymphocytosis, and astrogliosis with loss of myelin, confirming the diagnosis of tumefactive multiple sclerosis (TMS).
outcomeOver the subsequent two years, she experienced recurrent flares of TMS with new demyelinating lesions despite disease-modifying therapy (DMT) with ocrelizumab, resulting in progressive disability accrual.
human efficacyThis case also suggests that natalizumab may be considered in selected treatment-refractory cases, although further evidence is needed.
publication datePublication date: 2026-10-30
limitationsTitle: A Case of Treatment-Refractory Tumefactive Multiple Sclerosis Mimicking Brain Abscess.
peer reviewedPublication types: Journal Article
AI assessment, not yet reviewed by a person · version 1 · Community votes are separate from evidence review.