Tumefactive Multiple Sclerosis Mimicking a High-Grade Glioma: A Case Report and Literature Review.

Background and Clinical Significance: Tumefactive Multiple Sclerosis (TMS) represents a rare and diagnostically challenging form of demyelinating disease characterized by large space-occupying lesions that can closely mimic intracranial neoplasms, abscesses, and other inflammatory or vascular conditions. Case Presentation: The case highlights the overlapping radiologic features that frequently lead to diagnostic uncertainty and underscores the importance of careful interpretation of multimodal imaging and ancillary studies. Overall a comprehensive multidisciplinary evaluation is essential to reduce the risk of misdiagnosis and avoid unnecessary invasive interventions. Conclusions: This review summarizes current evidence regarding the diagnostic approach, imaging characteristics, and therapeutic strategies for tumefactive demyelinating lesions. Additionally, we present a clinical case that illustrates the diagnostic complexity of this entity, in which neuroimaging findings and cerebrospinal fluid analysis supported a demyelinating rather than neoplastic process.