Three Case Reports Of Multiple Sclerosis With Malignancy And Literature Review

Background:Multiple sclerosis is a kind of autoimmune disease of the central nervous system, with inflammatory demyelination in white matter as the main pathological feature. Its main clinical characteristics are multiple spatial lesions and relieve-relapsing course of disease. The lesions are mainly involved in the white matter of ventricle, optic nerve, spinal cord, brain stem and cerebellum. Most patients present with recurrent nerve dysfunction. So far, the etiology and pathogenesis of MS is unclear. It may be related to viral infection, immune reaction, genetic and environmental factors. Several studies have reported that MS can be complicated by other autoimmune diseases, but researches about MS with cancers are rarely reported. In this paper, three cases of multiple sclerosis with malignancy are analyzed and then we review the relevant literatures to explore whether there is a relationship between MS and malignant tumor.Objective:The aim is to discuss the relationship between MS and cancers, and to provide a basis for accurate diagnosis and optimal treatment of MS.Methods:The information of three cases of multiple sclerosis with malignancy, including clinical and laboratory data, images and treatments, were analyzed retrospectively. We searched the data of Pubmed, Web of Knowledeg, Embase, CNKI and Wan Fang, and got some relevant articles. Then we read the abstract or full text of these articles selectively. Discuss and sum the relationship between MS and cancers and research status.Results:Three patients all underwent multiple sclerosis with a malignant tumor. Two cases combined with glioma and the other combined with Hodgkin’s lymphoma. But the order of the occurred diseases was not same. The patient of case one accepted a surgical treatment for glioma, and five months later, the symptoms and signs of multiple sclerosis appeared. The case two patient was diagnosed with Hodgkin’s lymphoma after eight years of being diagnosed with multiple sclerosis. The lesions of glioma and multiple sclerosis were found simultaneously on the patient of case three. Three patients treated by surgery, radiotherapy chemotherapy, hormonal therapy and neuro nutrition drugs were improved and discharged. In the process of consulting literature materials, we found that the domestic reported cases of this type are relatively rare, and foreign studies on the relationship of multiple sclerosis and cancer are not yet clear. Through the above cases, we can speculate that multiple sclerosis can lead to some certain types of tumors, and treatment drugs of multiple sclerosis, such as interferon, may also be tumorigenic. Whether treatment of malignant tumors will aggravate or alleviate multiple sclerosis, this need more clinical studies to explore.Conclusion:Studies of cancer risk in MS patients have shown inconsistent findings. Patients with MS may have reduced risk in specific cancers such as respiratory organs, prostate, ovary, or increased risk in breast, brain and urinary tumors etc. This may because the hypothesis of an environmental factor influencing an already predisposing genetic/immunogenetic background. Persistent inflammation may promote tumorigenesis. However, immune-mediated disorders may have enhanced immunosurveillance due to activation of inflammatory cells, and consequently reduced tumorigenesis. Whether the clinical treatment of multiple sclerosis will increase the risk of cancer remains controversial. And we are unable to judge whether there are other factors mixed such as age, sex, race, socioeconomic status, medical history, lifestyle etc. Therefore, a lot of clinical researches are still needed to explore the mechanism and correlation between malignant tumors and multiple sclerosis.