This is a case of a 5-year-old boy who presented to the emergency department with 2 days of left-sided weakness. Magnetic resonance imaging (MRI) revealed 3 tumefactive lesions (Figure 1), the patient underwent lumbar punction and biopsy. The final diagnosis of Baló concentric sclerosis was made. He received intravenous methylprednisolone 30 mg/kg for 5 days, plasma exchange and immunoglobulin G course (2 g/kg/day). The patient was discharged in good condition and asymptomatic, he has had no more clinical episodes after 6 months of follow-up.
Baló’s concentric sclerosis (BCS) is a rare subtype of demyelinating disease with characteristic radiological and pathological features. In medical literature, less than 20 patients of BCS have been reported in pediatric population. Our case, combined with those in the literature, highlight the importance of considering demyelination in the differential diagnosis of tumefactive lesions. Distinguishing tumefactive demyelinating lesions from malignancy or infection is critical for proper patient management and to avoid unnecessary medical or surgical interventions.
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