Pediatric Tumefactive Multiple Sclerosis Case Report and Literature Review: A Saudi Experience

Tumefactive demyelinating lesions (TDLs) are rare, mass-like lesions that present a significant diagnostic challenge, often mimicking brain tumors on magnetic resonance imaging (MRI). This case report describes a 9-year-old male who presented with progressive neurological symptoms, including persistent headaches, ataxia, and dysarthria. MRI findings raised concerns for both demyelinating and neoplastic processes, but a biopsy confirmed the diagnosis of tumefactive multiple sclerosis (TMS). The patient was successfully treated with high-dose corticosteroids, resulting in marked clinical improvement. This case emphasizes the importance of differentiating TDLs from neoplasms, particularly in pediatric patients, and highlights the role of biopsy and advanced imaging techniques in achieving an accurate diagnosis. Long-term follow-up with disease-modifying therapies is crucial to prevent relapse and progression.