# Aggressive intracranial meningioma associated with multiple sclerosis: A case report and literature review

## TL;DR

A patient developed multiple sclerosis-like symptoms after radiation therapy for a meningioma, highlighting the challenge of distinguishing radiation-induced demyelination from MS.

## Contribution

This case report highlights the rare association between radiation-induced demyelination and subsequent multiple sclerosis diagnosis.

## Key findings

- Radiation therapy for meningioma can lead to demyelinating lesions resembling multiple sclerosis.
- Clinical history and advanced imaging are crucial for differentiating radiation-induced demyelination from MS.
- Radiation therapy may trigger or worsen multiple sclerosis in susceptible individuals.

## Abstract

Meningiomas are the most common primary tumors of the central nervous system (CNS) and often require radiation therapy (RT), which can lead to the development of complications, such as radiation-induced demyelination. The present study describes the case of a 40-year-old male patient who developed demyelinating lesions following RT for a WHO grade I meningioma, ultimately diagnosed with MS. This condition shares clinical and radiological features with multiple sclerosis, including damage to oligodendrocytes, which are the cells responsible for myelination in the CNS, cognitive impairment, motor dysfunction, and white matter abnormalities on magnetic resonance imaging (MRI). Distinguishing between radiation-induced demyelination and multiple sclerosis can be challenging, particularly in patients with a history of radiation therapy, as MRI findings often overlap. Additionally, radiation therapy may trigger or exacerbate multiple sclerosis in individuals with pre-existing risk factors or undiagnosed multiple sclerosis. A thorough clinical history, advanced neuroimaging, and careful differential diagnosis are essential for accurate management of these conditions.