1
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Sevindik B, Uysal E, Ugras S. A Rare Tumor Causing Optic and Oculomotor Nerve Compression: Clivus Plasmacytoma Case Report. Cureus 2024; 16:e62447. [PMID: 38882228 PMCID: PMC11180526 DOI: 10.7759/cureus.62447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2024] [Indexed: 06/18/2024] Open
Abstract
Plasmacytomas rarely affect the skull base and may be found as an isolated lesion or as a part of multiple myeloma. The typical feature of plasmacytomas is aggressive bone destruction in the skull. It is often confused with the chordoma of the clivus. The most common location for skull-base plasmacytomas is the nasopharynx. The most commonly affected cranial nerve in clivus tumors is the abducens nerve. In our 64-year-old male case, a plasmacytoma was detected in the clivus. There was ptosis and decreased vision due to optic nerve and oculomotor nerve involvement due to the plasmacytoma. Radiotherapy was applied for the treatment.
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Affiliation(s)
- Betul Sevindik
- Anatomy, Selcuk University Faculty of Medicine, Konya, TUR
| | - Emine Uysal
- Radiology, Selcuk University Faculty of Medicine, Konya, TUR
| | - Serdar Ugras
- Pathology, Selcuk University Faculty of Medicine, Konya, TUR
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2
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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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3
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mansouri H, elouaouch S, el youssi Z, guerrouaz MA, moukhlissi M, berhili S, mezouar L. Solitary plasmacytoma of the skull base: A case report and literature review. Radiol Case Rep 2023; 18:3894-3898. [PMID: 37670923 PMCID: PMC10475402 DOI: 10.1016/j.radcr.2023.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/18/2023] [Accepted: 08/04/2023] [Indexed: 09/07/2023] Open
Abstract
Plasmacytoma of the skull base is a rare entity. We present a case of sphenoid plasmacytoma in a 51-year-old woman who had nasal obstruction, intermittent epistaxis, headaches, decreasing visual acuity, and diplopia. Computed Tomography (CT) scan and magnetic resonance imaging (MRI) showed a large heterogeneous, expansile lesion measuring 75 mm × 54 mm, centered on the sphenoidal bone and the clivus. Biopsy confirmed the diagnosis of solitary plasmacytoma after ruling out systemic spread by the initial assessment. The patient was successfully managed by external beam radiotherapy and a complete response was obtained after 12 months of follow-up.
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Affiliation(s)
- Hanane mansouri
- Faculty of Medicine, Mohammed First University, Oujda, 60000, Morocco
- Department of Radiotherapy, Hassan II Oncology Center, Mohammed VI University Hospital Center, Oujda, 60000, Morocco
| | - Sofia elouaouch
- Faculty of Medicine, Mohammed First University, Oujda, 60000, Morocco
- Department of Radiotherapy, Hassan II Oncology Center, Mohammed VI University Hospital Center, Oujda, 60000, Morocco
| | - Zahira el youssi
- Faculty of Medicine, Mohammed First University, Oujda, 60000, Morocco
- Department of Radiotherapy, Hassan II Oncology Center, Mohammed VI University Hospital Center, Oujda, 60000, Morocco
| | - Mohammed Amine guerrouaz
- Faculty of Medicine, Mohammed First University, Oujda, 60000, Morocco
- Department of Radiotherapy, Hassan II Oncology Center, Mohammed VI University Hospital Center, Oujda, 60000, Morocco
| | - Mohamed moukhlissi
- Faculty of Medicine, Mohammed First University, Oujda, 60000, Morocco
- Department of Radiotherapy, Hassan II Oncology Center, Mohammed VI University Hospital Center, Oujda, 60000, Morocco
| | - Soufiane berhili
- Faculty of Medicine, Mohammed First University, Oujda, 60000, Morocco
- Department of Radiotherapy, Hassan II Oncology Center, Mohammed VI University Hospital Center, Oujda, 60000, Morocco
| | - Loubna mezouar
- Faculty of Medicine, Mohammed First University, Oujda, 60000, Morocco
- Department of Radiotherapy, Hassan II Oncology Center, Mohammed VI University Hospital Center, Oujda, 60000, Morocco
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4
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Nkie VE, Martin S. Fibrous Dysplasia of the Clivus: Case Report and Literature Review. Cureus 2023; 15:e45417. [PMID: 37854736 PMCID: PMC10581508 DOI: 10.7759/cureus.45417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 10/20/2023] Open
Abstract
Fibrous dysplasia is a benign, developmental bone disorder that causes fibrous replacement of normal skeletal tissue. This may lead to weakness, distortion, and tissue expansion. Fibrous dysplasia can occur anywhere in the body, including the craniofacial area. The clivus is a central skull bone formed by the bases of the sphenoid and occiput, respectively. The clivus is a rare, usually unrecognized, and seldom reported location for the development of fibrous dysplasia. Although fibrous dysplasia of the clivus (FDC) is usually discovered by incidental findings, it can sometimes present with clinical symptoms. In this case, we discuss a 30-year-old male who presents to the emergency room with headaches, altered mental status, and a prior presentation of location-related symptomatic epilepsy. Magnetic resonance imaging depicted a mass in the clivus, low in signal on T1 and mildly hypointense on T2 imaging. Follow-up computed tomography (CT) imaging, as recommended, revealed the classic presentation of FDC. In this paper, we discuss the significance of this condition and the importance of thorough investigation to rule out differential diagnoses that may present with similar acute symptoms as this patient.
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Affiliation(s)
- Veronica E Nkie
- Osteopathic Medicine-IV (OMS-IV), Alabama College of Osteopathic Medicine, Alabama, USA
| | - Sandra Martin
- Radiology, Coosa Valley Medical Center, Alabama, USA
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5
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Sharifi S, Asadi M. Extramedullary plasmacytoma of the sphenoid sinus presenting with visual loss: A case report. Clin Case Rep 2022; 10:e05758. [PMID: 35498354 PMCID: PMC9036194 DOI: 10.1002/ccr3.5758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/06/2022] [Accepted: 03/28/2022] [Indexed: 11/09/2022] Open
Abstract
A rare case of sphenoid plasmacytoma in a 62‐year‐old woman who was presented with a frozen eye is reported. It was histopathologically confirmed based on transsphenoidal biopsy. Moreover, initial evaluation ruled out systemic dissemination of the disease and solitary plasmacytoma was diagnosed. Surgical removal of the tumor with complementary radiotherapy was performed as a treatment modality.
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Affiliation(s)
- Sara Sharifi
- Otolaryngology Department Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Mahboobe Asadi
- Otolaryngology Department Shahid Beheshti University of Medical Sciences Tehran Iran
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6
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Khilji H, Silver C, Morrar D, Chhabra AM, Mandel S, Langer DJ, Shani D, Ellis JA. Complete Resolution of Skull Base Solitary Plasmacytoma Using Proton-Beam Radiotherapy: A Case Report. Cureus 2022; 14:e23130. [PMID: 35425679 PMCID: PMC9005338 DOI: 10.7759/cureus.23130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/05/2022] Open
Abstract
Cranial solitary plasmacytomas are uncommon lesions, and localization to the skull base is rare. Here we present a case in a 36-year-old woman who complained of dizziness and mild headaches. Radiographic imaging indicated the presence of a solitary skull base lesion in the posterior cranial fossa. Laboratory tests and imaging excluded systemic disease. A biopsy of the lesion confirmed the diagnosis of plasmacytoma. The patient was treated with proton-beam radiation and had a complete clinical and radiographic resolution, demonstrating the previously unreported utility of monotherapy with proton-beam radiation in such cases.
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7
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Seetahal-Maraj P, Knight P, Ramnarine N. Proptosis secondary to a solitary plasmacytoma of the sphenoid bone: a case report on a rare skull base tumour. EGYPTIAN JOURNAL OF NEUROSURGERY 2022. [DOI: 10.1186/s41984-022-00144-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Plasmacytomas of the skull base are not commonly encountered in clinical practice, with few reported cases in the literature. They form part of the spectrum of plasma cell neoplasms and are classified as a solitary bone plasmacytoma if arising from the sphenoid bone. Its radiographic appearance can lead to misdiagnosis as one of the tumours that are more frequently seen in the skull base, especially meningiomas. Due to the risk of evolution into multiple myeloma, accurate diagnosis is essential.
Case presentation
A 56-year-old male presented to the emergency department with rapid proptosis and worsening vision in his right eye for one week’s duration. Imaging studies revealed an extra-axial right sphenoid bone tumour with invasion into the temporalis muscle and orbit, leading to significant proptosis. Tumour debulking was done, but there was no improvement in vision postoperatively. Final histology was consistent with a plasmacytoma. The patient was referred to the oncologist for radiation therapy, but subsequently developed further lesions consistent with multiple myeloma.
Conclusions
Plasmacytomas need to be considered in the differential diagnosis of skull base tumours. Due to their excellent response to radiation, these patients should have early oncology intervention to prevent irreversible neurological deficits.
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8
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Sokhi DS, Mithi CW, Ebrahim FA, Salyani A, Waa S, Riyat MS. Collet-Sicard syndrome due to concurrent extramedullary intracranial plasmacytoma and jugular venous sinus thrombosis in multiple myeloma. Clin Case Rep 2021; 9:e04457. [PMID: 34336210 PMCID: PMC8319375 DOI: 10.1002/ccr3.4457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 05/11/2021] [Accepted: 05/25/2021] [Indexed: 11/27/2022] Open
Abstract
In a patient with Collet-Sicard syndrome and multiple myeloma, both extramedullary plasmacytomas and internal jugular vein-sigmoid sinus thrombosis should be considered as they can coexist.
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Affiliation(s)
- Dilraj Singh Sokhi
- Department of Medicine, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
| | - Caroline Wangui Mithi
- Department of Medicine, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
| | - Farah Alnoor Ebrahim
- Department of Medicine, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
| | - Adil Salyani
- Department of Medicine, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
| | - Sheila Waa
- Department of Radiology, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
| | - Malkit Singh Riyat
- Department of Oncology and Haematology, Faculty of Health SciencesThe Aga Khan University HospitalAga Khan University Medical College of East AfricaNairobiKenya
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9
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Abstract
Chordoma is a rare midline malignant tumor arising from embryonic remnants of the primitive notochord. The base of the skull is the second most common site of disease after the sacrococcygeal region. Intracranial chordoma constitutes about 30-35% of chordoma cases. Metastasis from chordoma is uncommon but if occurs, it tends to spread to the lungs. Cerebrospinal fluid seeding or drop metastasis is very rare. Here we describe a case of a clival chordoma with drop metastases.
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Affiliation(s)
| | - Vijayadwaja Desai
- Department of Pathology, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Lee Lian Chew
- Division of Oncologic Imaging, National Cancer Center Singapore, Singapore, Singapore
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10
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Lee J, Kulubya E, Pressman BD, Mamelak A, Bannykh S, Zada G, Cooper O. Sellar and clival plasmacytomas: case series of 5 patients with systematic review of 65 published cases. Pituitary 2017; 20:381-392. [PMID: 28251542 PMCID: PMC5429193 DOI: 10.1007/s11102-017-0799-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Parasellar plasmacytomas are rare tumors localized to the sellar region arising from plasma cells. Knowledge of clinical, imaging, surgical, and pathological characteristics is limited to single case reports. METHODS A retrospective analysis of five primary cases was conducted, followed by systematic review of English language articles using PubMed in accordance with PRISMA guidelines. RESULTS Five primary case patients include four men and one woman, ages 60-77, followed up to 3 years. A systematic review identified 65 additional patients, of whom 65% presented with cranial nerve palsies and 15% with hypopituitarism. Sixteen percent had history of known multiple myeloma (MM) while 37% were diagnosed concurrently with MM on presentation of parasellar plasmacytoma. Imaging showed median tumor size of 38 mm (range, 4-70 mm), with MRI intensity similar to that of other sellar masses. Surgical biopsy with immunohistochemical studies confirmed plasmacytoma diagnosis. Eighty-one percent underwent parasellar radiotherapy, and chemotherapy initiated in 59% of the 69 patients with MM. Overall survival rate was 74% at follow-up (median 12 months), with 18% having parasellar recurrences and 38% progressing to systemic MM after presentation of a solitary plasmacytoma (median 3 months). CONCLUSIONS Parasellar plasmacytomas are rare tumors that should be considered in the differential diagnosis for lesions involving the sella and arising from the clivus, especially when cranial nerve paresis is apparent, even in the absence of known MM. Although recurrence rates for parasellar plasmacytoma is low, patients should be monitored for progression to MM. Treatment depends on the presence of systemic disease at diagnosis.
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Affiliation(s)
- Jane Lee
- Pituitary Center, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Suite A6600, Los Angeles, CA, 90048, USA
| | - Edwin Kulubya
- Department of Neurosurgery, Keck School of Medicine of USC, 1200 North State Street, Suite 5046, Los Angeles, CA, 90089, USA
| | - Barry D Pressman
- Department of Radiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Suite M-335, Los Angeles, CA, 90048, USA
| | - Adam Mamelak
- Pituitary Center, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Suite A6600, Los Angeles, CA, 90048, USA
| | - Serguei Bannykh
- Department of Pathology, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Room 8725, Los Angeles, CA, 90048, USA
| | - Gabriel Zada
- Department of Neurosurgery, Keck School of Medicine of USC, 1200 North State Street, Suite 5046, Los Angeles, CA, 90089, USA
| | - Odelia Cooper
- Pituitary Center, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Suite A6600, Los Angeles, CA, 90048, USA.
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11
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Intracranial multiple myeloma may imitate subdural hemorrhage: How to overcome diagnostic limitations and avoid errors in treatment. Neurol Neurochir Pol 2017; 51:252-258. [DOI: 10.1016/j.pjnns.2017.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/23/2017] [Indexed: 10/19/2022]
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12
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Zamora C, Castillo M. Sellar and Parasellar Imaging. Neurosurgery 2016; 80:17-38. [DOI: 10.1093/neuros/nyw013] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 10/18/2016] [Indexed: 11/13/2022] Open
Abstract
Abstract
The skull base is a complex anatomical region that harbors many important neurovascular structures in a relatively confined space. The pathology that can develop at this site is varied, and many disease processes may present with similar clinical and neuroimaging findings. While computed tomography maintains a role in the evaluation of many entities and can, for instance, delineate osseous erosion with great detail and characterize calcified tumor matrices, magnetic resonance imaging (MRI) is the mainstay in the neuroimaging assessment of most pathology occurring at the skull base. Various MRI sequences have proven to be robust tools for tissue characterization and can provide information on the presence of lipids, paramagnetic and diamagnetic elements, and tumor cellularity, among others. In addition, currently available MRI techniques are able to generate high spatial resolution images that allow visualization of cranial nerves and their involvement by adjacent pathology. The information obtained from such examinations may aid in the distinction of these disease processes and in the accurate delineation of their extent prior to biopsy or treatment planning.
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13
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Rakul Nambiar K, Nair SG, Mathew SP. Vertigo and deafness: The sole presenting feature of multiple myeloma. J Egypt Natl Canc Inst 2016; 29:57-59. [PMID: 27771156 DOI: 10.1016/j.jnci.2016.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/06/2016] [Accepted: 09/19/2016] [Indexed: 11/25/2022] Open
Affiliation(s)
- K Rakul Nambiar
- Dept of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India.
| | - Sreejith G Nair
- Dept of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Sherin P Mathew
- Dept of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
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14
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Rahman EZ, Barros Palau AE, Morgan ML, Lee AG. Neuro-ophthalmic presentations of clival plasmacytoma. Can J Ophthalmol 2016; 51:e49-53. [DOI: 10.1016/j.jcjo.2015.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/03/2015] [Accepted: 10/28/2015] [Indexed: 10/21/2022]
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16
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Na'ara S, Amit M, Gil Z, Billan S. Plasmacytoma of the Skull Base: A Meta-Analysis. J Neurol Surg B Skull Base 2015; 77:61-5. [PMID: 26949590 DOI: 10.1055/s-0035-1560047] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 06/25/2015] [Indexed: 10/23/2022] Open
Abstract
Objective Extramedullary plasmacytomas are rare tumors. In the current study we aim to characterize its clinical course at the skull base and define the most appropriate therapeutic protocol. Methods We conducted a meta-analysis of articles in the English language that included data on the treatment and outcome of plasmacytoma of the base of skull. Results The study cohort consisted of 47 patients. The tumor originated from the clivus and sphenoclival region in 28 patients (59.5%), the nasopharynx in 10 patients (21.2%), the petrous apex in 5 patients (10.6%), and the orbital roof in 4 patients (8.5%). The chief complaints at presentation included recurrent epistaxis and cranial nerve palsy, according to the site of tumor. Twenty-two patients (46.8%) had surgical treatment; 25 (53.2%) received radiation therapy. Adjuvant therapy was administered in 11 cases (50%) with concurrent multiple myeloma. The 2-year and 5-year overall survival rates were 78% and 59%, respectively. Clear margin resection was achieved in a similar proportion of patients who underwent endoscopic surgery and open surgery (p = 0.83). A multivariate analysis of outcome showed a similar survival rate of patients treated surgically or with radiotherapy. Conclusions The mainstay of treatment for plasmacytoma is based on radiation therapy, but when total resection is feasible, endoscopic resection is a valid option.
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Affiliation(s)
- Shorook Na'ara
- Department of Otolaryngology, Head and Neck Surgery, The Head and Neck Center, Rambam Medical Campus, Haifa, Israel; The Laboratory for Applied Cancer Research, CRIR, Rambam Medical Campus, Haifa, Israel
| | - Moran Amit
- Department of Otolaryngology, Head and Neck Surgery, The Head and Neck Center, Rambam Medical Campus, Haifa, Israel; The Laboratory for Applied Cancer Research, CRIR, Rambam Medical Campus, Haifa, Israel
| | - Ziv Gil
- Department of Otolaryngology, Head and Neck Surgery, The Head and Neck Center, Rambam Medical Campus, Haifa, Israel; The Laboratory for Applied Cancer Research, CRIR, Rambam Medical Campus, Haifa, Israel
| | - Salem Billan
- Oncology Department, Rambam Medical Campus, Haifa, Israel
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17
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Kalwani N, Remenschneider AK, Faquin W, Ferry J, Holbrook EH. Plasmacytoma of the Clivus Presenting as Bilateral Sixth Nerve Palsy. J Neurol Surg Rep 2015; 76:e156-9. [PMID: 26251795 PMCID: PMC4520983 DOI: 10.1055/s-0035-1554930] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 03/12/2015] [Indexed: 11/30/2022] Open
Abstract
Background and Importance Plasmacytomas are monoclonal proliferations of plasma cells that may arise within soft tissue or bone. The skull base is a rare site for plasmacytomas to occur, and few cases have been reported in the literature. When present in the skull base, plasmacytomas may result in cranial neuropathies and often progress to multiple myeloma more rapidly than other intracranial or skeletal plasmacytomas. Clinical Presentation A 69-year-old man presented with a primary complaint of diplopia and an examination consistent with bilateral abducens nerve palsy. No other deficits were noted. Magnetic resonance imaging of the skull base demonstrated a large T1 isointense moderately enhancing lesion centered within the clivus. Endoscopic biopsy of the mass revealed sheets and aggregates of mature monoclonal plasma cells. The patient's initial systemic work-up revealed that this was a solitary lesion, and he was treated with radiation therapy to the skull base with a durable local effect at 18-month follow-up. Unfortunately he progressed to multiple myeloma with peripheral osteolytic lesions but has been stabilized on chemotherapeutics. Conclusion The clivus is an unusual site for intracranial plasmacytomas, and enhancing lesions must be differentiated from chordoma. Characteristic findings on histopathology include an immunoglobulin light-chain restricted clonal proliferation of plasma cells. Treatment is most commonly radiotherapy with surgery reserved for biopsy and palliation. Clinicians should be aware of the increased risk of progression to multiple myeloma in skull base plasmacytomas.
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Affiliation(s)
- Neil Kalwani
- Section of Otology and Laryngology, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
| | - Aaron K Remenschneider
- Section of Otology and Laryngology, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
| | - William Faquin
- Section of Pathology, Department of Otolaryngology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Judith Ferry
- Section of Pathology, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Eric H Holbrook
- Section of Otology and Laryngology, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
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18
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Jadhav AB, Tadinada A, Rengasamy K, Fellows D, Lurie AG. Clival lesion incidentally discovered on cone-beam computed tomography: A case report and review of the literature. Imaging Sci Dent 2014; 44:165-9. [PMID: 24944968 PMCID: PMC4061302 DOI: 10.5624/isd.2014.44.2.165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 12/11/2013] [Accepted: 12/15/2013] [Indexed: 12/21/2022] Open
Abstract
An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.
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Affiliation(s)
- Aniket B Jadhav
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Aditya Tadinada
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Kandasamy Rengasamy
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Douglas Fellows
- Division of Diagnostic Sciences and Therapeutics, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Alan G Lurie
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
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Gagliardi F, Losa M, Boari N, Spina A, Reni M, Terreni MR, Mortini P. Solitary clival plasmocytomas: Misleading clinical and radiological features of a rare pathology with a specific biological behaviour. Acta Neurochir (Wien) 2013; 155:1849-56. [PMID: 23975648 DOI: 10.1007/s00701-013-1845-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 08/10/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Tumours of the clivus are exceptionally rare, representing a diagnostic and a therapeutic challenge. Clival solitary plasmocytomas have been described only as single case reports or included in small clinical series with other intracranial location. METHODS Authors report clinical, radiological, and survival data of four patients, who underwent surgery for clival plasmocytomas between 1989 and 2012 in a single centre. Current knowledge about solitary plasmocytomas of the clivus are reviewed. RESULTS Follow-up time was 54 months (range: 9-165). Mean age of patient was 57 years, no gender predilection was observed. Main symptoms were headache (75 %) and double vision (75 %), due to third or sixth cranial nerve palsy. Mean time to diagnosis was 8.2 months. All patients underwent surgery as primary treatment, through either a transsphenoidal (75 %) or a transmaxillary approach (25 %). In all cases adjuvant conventional radiotherapy was performed with a median delivered dose of 45 Gy. Only one case of progression into multiple myeloma was observed 13 months after surgery, and the patient died 9 months later. No other recurrences or progression were observed. Mean overall survival and progression free survival time were, respectively, 54 and 51.7 months. CONCLUSIONS Although extremely rare, clival plasmocytomas have to be considered in the differential diagnosis of a solitary clival lesion. Biological and clinical features of these tumours strongly differ from those of similar lesions in other part of the body. Early diagnosis, extensive tumour removal, opportune indication of adjuvant treatment with radiotherapy and chemotherapy are the keys to manage these cases.
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Affiliation(s)
- Filippo Gagliardi
- Department of Neurosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy,
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Ágreda Moreno B, Urpegui García Á, López Vázquez A, Vallés Varela H. Extramedullary Plasmacytoma as an Exceptional Location in Frontal Sinus. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2013. [DOI: 10.1016/j.otoeng.2013.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Gürbüz MS, Akmil MU, Akar E, Aker FV. Solitary plasmocytoma of the skull. BMJ Case Rep 2013; 2013:bcr-2013-200379. [PMID: 23929613 DOI: 10.1136/bcr-2013-200379] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 63-year-old man presented with a 4-month history of a slowly growing soft mass at his right parieto-occipital region. Neuroradiological examinations revealed an osteolytic extradural tumour of the skull vault. The outer and inner tables of the skull were partially destroyed by the tumour, but the dura was not involved. The tumour and the invaded bone were totally removed and the skull defect was reconstructed using the outer table of the adjacent intact skull. Histopathological examination confirmed plasmocytoma. Laboratory investigations revealed no systemic myelomatosis. It is very important to differentiate solitary plasmocytoma from systemic myelomatosis since their treatment and prognosis are different. Although the prognosis of solitary plasmocytoma is good, regular follow-up examinations are required for any possibility to progress to systemic myelomatosis.
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Dong L, Zhang X, Zhang H, Song R, Gu X, He L. Solitary plasmacytoma of the skull: Two case reports. Oncol Lett 2012; 5:479-482. [PMID: 23420663 PMCID: PMC3573150 DOI: 10.3892/ol.2012.1046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 10/17/2012] [Indexed: 12/05/2022] Open
Abstract
Solitary plasmacytoma of the skull is rare and few cases have been reported in the English literature. Plasmacytoma of the skull has a wide spectrum of pathology, including a quite benign, solitary plasmacytoma (SPC), and an extremely malignant, multiple myeloma (MM) at the two ends of the spectrum. The prognosis for solitary plasmacytoma of the skull appears to be good when it can be diagnosed on strict criteria. The clinical features of solitary plasmacytoma of the skull are complex and not easily identified, resulting in a high misdiagnosis rate. A comprehensive examination and analysis which includes radiological examination, immunoglobulin, biochemistry, test for Bence Jones protein in the urine and bone marrow is needed for correct diagnosis. If the skull lesion is isolated, with accompanying marked swelling in the area and tenderness, plasmacytoma must be considered as a possibility for the cause of solitary skull masses. Two cases of solitary plasmacytoma of the skull lesions were retrospectively reviewed, in which a comprehensive examination was used in order to predict the clinical course of solitary plasmacytoma of the skull. The patients received postoperative radiation and/or chemotherapy. Survival following surgery was longer than 2 years for patient 1, and patient 2 is alive at the 18-month follow-up.
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Affiliation(s)
- Lun Dong
- Departments of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou 225001, Jiangsu, P.R. China
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24
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Gangadhar K, Santhosh D, Kallahalli S. A rare differential diagnosis for cause of proptosis: skull plasmacytoma. Neuroradiol J 2012; 25:374-8. [PMID: 24028993 DOI: 10.1177/197140091202500315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 03/13/2012] [Indexed: 11/16/2022] Open
Abstract
True solitary plasmacytoma of the skull without signs of systemic myelomatosis is very rare as is orbital involvement. It can be part of generalized disease (multiple myeloma) or localized disease, presenting as orbital tumor. We describe a case of solitary osseous plasmacytoma of the orbit. This 40-year-old man presented with a four month history of proptosis of the left eye, swelling in the left orbito-temporal region with a mild decrease in visual acuity. Multidetector row computed tomography scan showed a geographic osteolytic, well-demarcated lesion involving the greater wing of the sphenoid bone showing homogeneous contrast enhancement with extra-axial extension to the middle and anterior cranial fossa extension with extraconal extension into the orbit at the right side. Fine needle and later biopsy of the lesion revealed plasmacytoma.
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Affiliation(s)
- K Gangadhar
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University; Varanasi, India -
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25
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Extramedullary plasmacytoma as an exceptional location in frontal sinus. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2012; 64:374-6. [PMID: 22502735 DOI: 10.1016/j.otorri.2012.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 02/19/2012] [Accepted: 02/21/2012] [Indexed: 11/24/2022]
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Lakhdar F, Arkha Y, Derraz S, Ouahabi AE, Khamlichi AE. [Solitary intrasellar plasmocytoma revealed by a diplopia: a case report]. Neurochirurgie 2011; 58:37-9. [PMID: 22088574 DOI: 10.1016/j.neuchi.2011.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 07/21/2011] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Plasmocytomas rarely invade the skull base. It can be solitary or multiple. The clinical presentation mainly consists in a progressive neuropathy involving many cranial nerves, or may simply present as an optochiasmatic syndrome. OBSERVATION The authors report a case of a female patient aged 68 years presenting with an optochiasmatic syndrome with an anosmia and paralysis of the right sixth (VI) cranial nerve progressing over two years prior to her hospitalisation. Cerebral MRI showed a voluminous intrasellar lesion, isointense on T1 and hyperintense on T2, enhancing intensely after gadolinium injection with evidence of invasion of the sphenoid and cavernous sinuses. The endocrinologic assay was normal. A sphenoidal biopsy by the rhinoseptal route permitted the diagnosis of a plasmocytoma. A complete radiologic and laboratory assessment of the patient was accomplished, the patient benefited from local radiotherapy. DISCUSSION Plasmocytomas are malignant tumors that are essentially osseous. The cervicocephalic region is rarely afflicted (1%). Extension to the cranial base seldom occurs. Less than 30 cases have been described in the literature simulating the other numerous neoplastic intrasellar lesions. CONCLUSION Plasmocytomas of the cranial base revealing a myeloma represent a very rare entity. Nevertheless, whether solitary or multiple, a plasmocytoma must be considered amongst the differential diagnoses in the face of any invasive lesion of the sphenoid sinus.
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Affiliation(s)
- F Lakhdar
- Service de neurochirurgie, hôpital des spécialités ONO, CHU, Rabat, Maroc.
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27
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Razek AAKA. Imaging appearance of bone tumors of the maxillofacial region. World J Radiol 2011; 3:125-34. [PMID: 21666818 PMCID: PMC3110914 DOI: 10.4329/wjr.v3.i5.125] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Revised: 04/25/2011] [Accepted: 05/02/2011] [Indexed: 02/06/2023] Open
Abstract
This paper reviews the imaging appearance of benign and malignant bone tumors of the maxillofacial region. A benign bone tumor commonly appears as a well circumscribed lesion. The matrix of the tumor may be calcified or sclerotic. Malignancies often display aggressive characteristics such as cortical breakthrough, bone destruction, a permeative pattern and associated soft-tissue masses. Computed tomography scan is an excellent imaging modality for accurate localization of the lesion, characterization of the tumor matrix and detection of associated osseous changes such as bone remodeling, destruction or periosteal reaction. Magnetic resonance imaging is of limited value in the evaluation of maxillofacial bone tumors.
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28
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Lagarde J, Cret C, Karlin L, Ameri A. [Petrous plasmacytoma revealed by a painful peripheral facial palsy]. Rev Neurol (Paris) 2011; 167:526-9. [PMID: 21195441 DOI: 10.1016/j.neurol.2010.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Accepted: 10/13/2010] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The classical hypothesis of Bell's palsy, tempting in cases of peripheral facial palsy of rapid onset, must nevertheless be evoked with caution particularly if an intense pain is present, which should lead to search for a tumor of the skull base, especially the petrous bone. CASE REPORT A 43-year-old man presented a peripheral facial palsy of rapidly progressive onset. A petrous bone tumor was diagnosed on the CT scan, which revealed an aspect of a glomic tumor or a metastatic lesion. The final histological diagnosis was plasmacytoma. DISCUSSION This type of tumor has been rarely reported in this location. The radiological features are not specific at all, underlying the importance of searching for some associated signs such as a monoclonal protein and performing a histological examination when the firm diagnosis of a systemic disease like multiple myeloma has not been possible.
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Affiliation(s)
- J Lagarde
- Service de Neurologie, Centre Hospitalier de Meaux, 6-8 rue Saint-Fiacre, 77104 Meaux cedex, France.
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Plaut J, Galloway M, Childerhouse A, Bradford R. Schwannoma with monoclonal plasma cell infiltration. J Neurosurg 2009; 111:509-11. [PMID: 19374503 DOI: 10.3171/2009.3.17682] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors report a very rare case of a vestibular schwannoma with an infiltrate of monoclonal plasma cells. A 45-year-old woman underwent routine excision of a presumed vestibular schwannoma. Histological analysis revealed the presence of a distinct lambda light chain restricted plasma cell population within the schwannoma. The light chain restriction and polymerase chain reaction-demonstrated monoclonality of the plasma cell population suggested the co-occurrence of a plasma cell neoplasm within a schwannoma. A search for systemic disease of plasma cell origin was unremarkable. A search of the literature suggests that this is the first report of such an occurrence.
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Affiliation(s)
- Joshua Plaut
- Department of Neurosurgery, Royal Free Hospital, London, UK.
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Park SH, Kim YZ, Lee EH, Kim KH. Endoscopic endonasal transsphenoidal resection of solitary extramedullary plasmacytoma in the sphenoid sinus with destruction of skull base. J Korean Neurosurg Soc 2009; 46:156-60. [PMID: 19763219 DOI: 10.3340/jkns.2009.46.2.156] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Revised: 01/11/2009] [Accepted: 08/03/2009] [Indexed: 11/27/2022] Open
Abstract
Solitary extramedullary plasmacytomas are isolated plasma cell tumors of soft tissue that typically do not metastasize. They are rare and account for 4% of all plasma cell tumors. To our knowledge, only 14 cases of solitary extramedullary plasmacytomas in the sphenoid sinus have been reported. A 32-year-old man presented to our department with complaint of ocular pain in the right eyeball and diplopia. Physical and neurological examinations revealed intact and prompt direct and indirect light reflexes in both pupils and limitation of extraocular muscle movement seen with the lateral gaze of the right eyeball. Magnetic resonance imaging suggested the presence of mucocele or mycetoma, therefore surgical resection was performed with endoscopic endonasal transsphenoidal approach. Histopathology was consistent with plasmacytoma. Systemic work-up did not show any evidence of metastasis and the sphenoid sinus was the sole tumor site, and therefore the diagnosis of solitary extramedullary plasmacytoma was confirmed. We report a rare case of solitary extramedullary plasmacytoma in the sphenoid sinus with successful treatment using the endoscopic endonasal transsphenoidal resection and adjuvant radiotherapy.
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Affiliation(s)
- Sung Hoon Park
- Department of Neurosurgery, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea
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Eum JHD, Jeibmann A, Wiesmann W, Paulus W, Ebel H. Multiple myeloma manifesting as an intraventricular brain tumor. J Neurosurg 2009; 110:737-9. [DOI: 10.3171/2008.2.17652] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Primary intracerebral manifestation of multiple myeloma is rare and usually arises from the meninges or brain parenchyma. The authors present a case of multiple myeloma primarily manifesting within the lateral ventricle. A 67-year-old man was admitted with headache accompanied by slowly progressing right hemiparesis. Magnetic resonance imaging showed a large homogeneous contrast-enhancing intraventricular midline mass and hydrocephalus. The tumor was completely resected, and histopathological examination revealed plasmacytoma. After postoperative radio- and chemotherapy, vertebral osteolysis was detected as a secondary manifestation of multiple myeloma.
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Affiliation(s)
| | - Astrid Jeibmann
- 2Institute of Neuropathology, University Hospital of Münster, Germany
| | | | - Werner Paulus
- 2Institute of Neuropathology, University Hospital of Münster, Germany
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Feller L, White J, Wood NH, Bouckaert M, Lemmer J, Raubenheimer EJ. Extramedullary myeloma in an HIV-seropositive subject. Literature review and report of an unusual case. Head Face Med 2009; 5:4. [PMID: 19152712 PMCID: PMC2649913 DOI: 10.1186/1746-160x-5-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Accepted: 01/20/2009] [Indexed: 11/29/2022] Open
Abstract
Myeloma is characterized by monoclonal bone marrow plasmacytosis, the presence of M-protein in serum and/or in urine and osteolytic bone lesions. HIV-seropositive subjects with myeloma are younger at the time of diagnosis of the tumour and usually the myeloma has a more aggressive clinical course than it does in HIV-seronegative subjects. A case of an HIV-seropositive woman in whom myeloma was diagnosed following progressive swelling of the face, is reported. In addition to bone marrow plasmacytosis and the presence of M-protein in the serum, the patient had an extramedullary lesion affecting the oral cavity, maxilla, parotid gland and paranasal sinuses, and extending intracranially and intraorbitally.
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Affiliation(s)
- Liviu Feller
- Department of Periodontology and Oral Medicine, School of Dentistry, University of Limpopo, Pretoria, South Africa.
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Yamaguchi S, Terasaka S, Ando S, Shinohara T, Iwasaki Y. Neoadjuvant therapy in a patient with clival plasmacytoma associated with multiple myeloma: a case report. ACTA ACUST UNITED AC 2008; 70:403-7. [DOI: 10.1016/j.surneu.2007.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Accepted: 10/09/2007] [Indexed: 10/22/2022]
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