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Chadli S, Oudrhiri MY, Maamar M, Boutarbouch M, Khibri H, Haidouri S, Messaoud O, El-Aoufir O, Melhaoui A, Ammouri W, Ouahabi A, Harmouche H, Adnaoui M, Tazi Mezalek Z. Sphenoid plasmacytoma as initial presentation of multiple myeloma-case report. J Surg Case Rep 2024; 2024:rjae199. [PMID: 38572279 PMCID: PMC10987209 DOI: 10.1093/jscr/rjae199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
Plasmacytoma is a rare plasma cell neoplasm. Whether solitary or associated with multiple myeloma (MM), it rarely involves the skull base, particularly the sphenoid bone. We present a unique case of sphenoid bone plasmacytoma secondary to MM, highlighting diagnostic and therapeutic challenges. A 56-year-old female presented with headaches, vomiting, epistaxis, and cranial nerve deficits. Cerebral imaging revealed a 65-mm tumor infiltrating the sphenoid bone and adjacent structures. Subtotal resection was performed using an endoscopic nasal approach. Histopathology revealed plasmacytoma, and diagnostic workup confirmed MM. By the end of biological exploration, relapse of the sphenoid plasmacytoma was observed, and the patient was successfully treated with radiotherapy, immunochemotherapy, and autologous stem cell transplantation. After 18-month follow-up, sustained complete remission was confirmed. Although rare, the diagnosis of plasmacytoma should be considered in cases of skull base tumors. This localization is highly predictive of MM, warranting comprehensive investigations to initiate prompt and adequate management.
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Affiliation(s)
- Sarra Chadli
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Mohammed Y Oudrhiri
- Neurosurgery HSR, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Mouna Maamar
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Mahjouba Boutarbouch
- Neurosurgery HSR, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Hajar Khibri
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Soukaina Haidouri
- Clinical Hematology, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Ola Messaoud
- Radiology, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Omar El-Aoufir
- Radiology, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Adyl Melhaoui
- Neurosurgery HSR, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Wafaa Ammouri
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Abdessamad Ouahabi
- Neurosurgery HSR, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Hicham Harmouche
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Mohammed Adnaoui
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Zoubida Tazi Mezalek
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
- Clinical Hematology, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
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