Thr eases of two young women with a homonymous hemianopia ore described. Bo
th women had a progressively enlarging mass lesion that was seen with neuro
imaging studies. One patient had neurologic deterioration despite intraveno
us corticosteroid treatment. In each ease, results of a stereotactic biopsy
showed demyelination that was consistent with multiple sclerosis. Multiple
sclerosis infrequently presents as a mass lesion. The atypical clinical an
d radiographic features of large demyelinating plaques may lead to an erron
eous diagnosis of a brain tumor, infection, or demyelination from other cau
ses.