Intense Hypermetabolic Tumefactive Demyelination on 18F-FDG PET and MRI Related to Multiple Sclerosis Relapse After Fingolimod Suspension

Gabriela Almeida Pimentel; Artur Martins Coutinho; Luis Filipe de Souza Godoy; Luiz Guilherme Cernaglia A de Lima; Daniel Ciampi de Andrade

doi:10.1097/RLU.0000000000003419

Intense Hypermetabolic Tumefactive Demyelination on 18F-FDG PET and MRI Related to Multiple Sclerosis Relapse After Fingolimod Suspension

Gabriela Almeida Pimentel, Artur Martins Coutinho, Luis Filipe de Souza Godoy, Luiz Guilherme Cernaglia A de Lima, Daniel Ciampi de Andrade

Research output: Contribution to journal › Conference abstract in journal › Research › peer-review

Abstract

ABSTRACT: A 57-year-old woman with a history of multiple sclerosis presented with a 5-day history of progressive headache and confusion, followed by left hemiparesis. The patient had stopped her previous fingolimod usage during the last 8 weeks. Brain MRI and 18F-FDG PET showed a subcortical tumefactive lesion with an intense peripheric rim of hypermetabolism and central hypometabolism, with central hyperintensity, thin isointense rim, and peripheral finger-like "tentacles" of edema with an irregular and thick border enhancement on postcontrast T2-weighted MRI. Brain biopsy showed features suggestive of relapsing MS. The patient improved after methylprednisone and plasma exchange.

Original language	English
Journal	Clinical Nuclear Medicine
Volume	46
Issue number	4
Pages (from-to)	e198-e199
ISSN	0363-9762
DOIs	https://doi.org/10.1097/RLU.0000000000003419
Publication status	Published - 1 Apr 2021
Externally published	Yes

Bibliographical note

Keywords

Biopsy
Female
Fingolimod Hydrochloride/pharmacology
Fluorodeoxyglucose F18
Humans
Magnetic Resonance Imaging
Middle Aged
Multimodal Imaging
Multiple Sclerosis/diagnostic imaging
Myelin Sheath/metabolism
Positron-Emission Tomography
Recurrence
Withholding Treatment

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@article{45b38f582d164aa9a9e9b9b19d0e75ab,

title = "Intense Hypermetabolic Tumefactive Demyelination on 18F-FDG PET and MRI Related to Multiple Sclerosis Relapse After Fingolimod Suspension",

abstract = "ABSTRACT: A 57-year-old woman with a history of multiple sclerosis presented with a 5-day history of progressive headache and confusion, followed by left hemiparesis. The patient had stopped her previous fingolimod usage during the last 8 weeks. Brain MRI and 18F-FDG PET showed a subcortical tumefactive lesion with an intense peripheric rim of hypermetabolism and central hypometabolism, with central hyperintensity, thin isointense rim, and peripheral finger-like {"}tentacles{"} of edema with an irregular and thick border enhancement on postcontrast T2-weighted MRI. Brain biopsy showed features suggestive of relapsing MS. The patient improved after methylprednisone and plasma exchange.",

keywords = "Biopsy, Female, Fingolimod Hydrochloride/pharmacology, Fluorodeoxyglucose F18, Humans, Magnetic Resonance Imaging, Middle Aged, Multimodal Imaging, Multiple Sclerosis/diagnostic imaging, Myelin Sheath/metabolism, Positron-Emission Tomography, Recurrence, Withholding Treatment",

author = "Pimentel, {Gabriela Almeida} and Coutinho, {Artur Martins} and {de Souza Godoy}, {Luis Filipe} and {de Lima}, {Luiz Guilherme Cernaglia A} and {de Andrade}, {Daniel Ciampi}",

year = "2021",

month = apr,

day = "1",

doi = "10.1097/RLU.0000000000003419",

language = "English",

volume = "46",

pages = "e198--e199",

journal = "Clinical Nuclear Medicine",

issn = "0363-9762",

publisher = "Lippincott Williams & Wilkins",

number = "4",

}

Intense Hypermetabolic Tumefactive Demyelination on 18F-FDG PET and MRI Related to Multiple Sclerosis Relapse After Fingolimod Suspension. / Pimentel, Gabriela Almeida; Coutinho, Artur Martins; de Souza Godoy, Luis Filipe et al.
In: Clinical Nuclear Medicine, Vol. 46, No. 4, 01.04.2021, p. e198-e199.

Research output: Contribution to journal › Conference abstract in journal › Research › peer-review

TY - ABST

T1 - Intense Hypermetabolic Tumefactive Demyelination on 18F-FDG PET and MRI Related to Multiple Sclerosis Relapse After Fingolimod Suspension

AU - Pimentel, Gabriela Almeida

AU - Coutinho, Artur Martins

AU - de Souza Godoy, Luis Filipe

AU - de Lima, Luiz Guilherme Cernaglia A

AU - de Andrade, Daniel Ciampi

PY - 2021/4/1

Y1 - 2021/4/1

N2 - ABSTRACT: A 57-year-old woman with a history of multiple sclerosis presented with a 5-day history of progressive headache and confusion, followed by left hemiparesis. The patient had stopped her previous fingolimod usage during the last 8 weeks. Brain MRI and 18F-FDG PET showed a subcortical tumefactive lesion with an intense peripheric rim of hypermetabolism and central hypometabolism, with central hyperintensity, thin isointense rim, and peripheral finger-like "tentacles" of edema with an irregular and thick border enhancement on postcontrast T2-weighted MRI. Brain biopsy showed features suggestive of relapsing MS. The patient improved after methylprednisone and plasma exchange.

AB - ABSTRACT: A 57-year-old woman with a history of multiple sclerosis presented with a 5-day history of progressive headache and confusion, followed by left hemiparesis. The patient had stopped her previous fingolimod usage during the last 8 weeks. Brain MRI and 18F-FDG PET showed a subcortical tumefactive lesion with an intense peripheric rim of hypermetabolism and central hypometabolism, with central hyperintensity, thin isointense rim, and peripheral finger-like "tentacles" of edema with an irregular and thick border enhancement on postcontrast T2-weighted MRI. Brain biopsy showed features suggestive of relapsing MS. The patient improved after methylprednisone and plasma exchange.

KW - Biopsy

KW - Female

KW - Fingolimod Hydrochloride/pharmacology

KW - Fluorodeoxyglucose F18

KW - Humans

KW - Magnetic Resonance Imaging

KW - Middle Aged

KW - Multimodal Imaging

KW - Multiple Sclerosis/diagnostic imaging

KW - Myelin Sheath/metabolism

KW - Positron-Emission Tomography

KW - Recurrence

KW - Withholding Treatment

U2 - 10.1097/RLU.0000000000003419

DO - 10.1097/RLU.0000000000003419

M3 - Conference abstract in journal

C2 - 33323727

SN - 0363-9762

VL - 46

SP - e198-e199

JO - Clinical Nuclear Medicine

JF - Clinical Nuclear Medicine

IS - 4

ER -

Intense Hypermetabolic Tumefactive Demyelination on 18F-FDG PET and MRI Related to Multiple Sclerosis Relapse After Fingolimod Suspension

Abstract

Bibliographical note

Keywords

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