SOLITARY FOCAL DEMYELINATION IN THE BRAIN AS A PARANEOPLASTIC DISORDER

Solitary focal demyelination (SFD) in the brain is an uncommon and poo rly understood disorder of uncertain etiology that may represent an in termediate entity between multiple sclerosis and acute disseminated en cephalomyelitis. In a few reported cases of SFD, the patient was brief ly noted to have a nonneurological malignancy. We studied two patients who had solitary focal lesions in the brain. Utilizing magnetic reson ance imaging and tissue biopsy, we found the characteristics of the br ain lesions in these two patients to be those of SFD. In our combined experience over the past 10 years, we have encountered no similar brai n lesions at our medical center. We found it remarkable that both of t hese patients also had malignancy outside of the nervous system. One h ad a seminoma, and the other a lymphoma. We conclude that some cases o f SFD in the brain may occur as a paraneoplastic disorder associated w ith nonneurological malignancies. (C) 1996 Wiley-Liss, Inc.