SynthesisBMC neurology2026
Biopsy-proven tumefactive demyelinating lesions: a systematic review and meta-analysis.
Synthesis in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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4 authors.
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Abstract
backgroundA tumefactive demyelinating lesion (TDL) is an area of pathological changes in the central nervous system consistent with demyelination, larger than 2 cm, and can mimic tumors on imaging; hence the term "tumefactive." TDLs are often challenging, as they have been reported in isolation or in conjunction with demyelinating diseases.
objectivesTo describe the clinical and radiological features of TDLs, explore the treatments used and outcomes, and describe different nomenclatures reported.
methodsWe followed PRISMA guidelines, and our protocol was registered on PROSPERO [CRD42024593078]. We searched PubMed, Web of Science, EMBASE, and Google Scholar. We included published cases with TDL (> 2 cm) on magnetic resonance imaging (MRI) in patients aged ≥ 18 years. We excluded a priori any established diagnoses of the lesions other than TDLs, cases without biopsy confirmation of demyelination, and cases lacking relevant data. The study framework is exploratory and descriptive in nature, and analyses are taken as hypothesis-generating. Comprehensive Meta-Analysis V3.0 was used for meta-analyses.
resultsWe examined 112 cases from 51 publications. The average age was 41.5 years, with women representing 54% of patients. MRI revealed solitary lesions in 65% of cases, mainly in the frontal (35%) and parietal (28%) lobes, with a mean lesion size of 4.25 ± 1.32 cm. CSF analysis showed oligoclonal bands in 20% of cases. The meta-analysis demonstrated a 72% pooled response rate to intravenous methylprednisolone (IVMP) (95% CI: 57.9% - 83.2%, p < 0.01), with moderate heterogeneity (I
conclusionAcute IVMP treatment had a high response rate and similar use rate. Despite variations in nomenclature and presentation, the broader pathological and clinical features, as well as the response to IVMP in TDLs, appear broadly similar across studies, acknowledging the methodological limitations of the available literature. Our study was also limited by the small sample due to the rarity of the condition.
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