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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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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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3
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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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Bordes SJ, Najera E, Obrzut M, Borghei-Razavi H, Adada B. Intracranial Plasmacytoma Mimicking a Cavernous Sinus Meningioma. Cureus 2021; 13:e12716. [PMID: 33614321 PMCID: PMC7883569 DOI: 10.7759/cureus.12716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Extramedullary plasmacytomas involving the cavernous sinus are rare manifestations of multiple myeloma, and management strategies for such a pathology are not extensively discussed in the literature. In this case report, we describe the case of a patient presenting with a cavernous sinus syndrome secondary to a presumed meningioma. Surgical intervention was avoided as a computed tomography-guided biopsy was performed yielding the diagnosis of a cavernous sinus plasmacytoma. Neurointerventional radiology obtained the cavernous sinus mass biopsy using an approach through the maxillary bone and sinus. Histopathology identified sheets of atypical plasma cells, and the patient was referred to radiation oncology for further management.
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Affiliation(s)
- Stephen J Bordes
- Anatomical Sciences, St. George's University School of Medicine, St. George's, GRD.,Anatomical Sciences, Tulane University School of Medicine, New Orleans, USA
| | | | | | - Hamid Borghei-Razavi
- Neurosurgery, Neurological Institute, Cleveland Clinic - Taussig Cancer Center, Cleveland, USA
| | - Badih Adada
- Neurosurgery, Cleveland Clinic Florida, Weston, USA
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Mahalingam HV, Mani SE, Patel B, Prabhu K, Alexander M, Fatterpekar GM, Chacko G. Imaging Spectrum of Cavernous Sinus Lesions with Histopathologic Correlation. Radiographics 2019; 39:795-819. [DOI: 10.1148/rg.2019180122] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Harsha Vardhan Mahalingam
- From the Departments of Radiology (H.V.M., S.E.M.), Pathology (B.P., G.C.), Neurosurgery (K.P.), and Neurology (M.A.), Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu 632004, India; and the Department of Radiology, NYU Langone Medical Center, New York, NY (G.M.F.)
| | - Sunithi E. Mani
- From the Departments of Radiology (H.V.M., S.E.M.), Pathology (B.P., G.C.), Neurosurgery (K.P.), and Neurology (M.A.), Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu 632004, India; and the Department of Radiology, NYU Langone Medical Center, New York, NY (G.M.F.)
| | - Bimal Patel
- From the Departments of Radiology (H.V.M., S.E.M.), Pathology (B.P., G.C.), Neurosurgery (K.P.), and Neurology (M.A.), Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu 632004, India; and the Department of Radiology, NYU Langone Medical Center, New York, NY (G.M.F.)
| | - Krishna Prabhu
- From the Departments of Radiology (H.V.M., S.E.M.), Pathology (B.P., G.C.), Neurosurgery (K.P.), and Neurology (M.A.), Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu 632004, India; and the Department of Radiology, NYU Langone Medical Center, New York, NY (G.M.F.)
| | - Mathew Alexander
- From the Departments of Radiology (H.V.M., S.E.M.), Pathology (B.P., G.C.), Neurosurgery (K.P.), and Neurology (M.A.), Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu 632004, India; and the Department of Radiology, NYU Langone Medical Center, New York, NY (G.M.F.)
| | - Girish M. Fatterpekar
- From the Departments of Radiology (H.V.M., S.E.M.), Pathology (B.P., G.C.), Neurosurgery (K.P.), and Neurology (M.A.), Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu 632004, India; and the Department of Radiology, NYU Langone Medical Center, New York, NY (G.M.F.)
| | - Geeta Chacko
- From the Departments of Radiology (H.V.M., S.E.M.), Pathology (B.P., G.C.), Neurosurgery (K.P.), and Neurology (M.A.), Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu 632004, India; and the Department of Radiology, NYU Langone Medical Center, New York, NY (G.M.F.)
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D'Aguillo C, Soni RS, Gordhan C, Liu JK, Baredes S, Eloy JA. Sinonasal extramedullary plasmacytoma: a systematic review of 175 patients. Int Forum Allergy Rhinol 2013; 4:156-63. [DOI: 10.1002/alr.21254] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 10/22/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Christine D'Aguillo
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
| | - Resha S. Soni
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
| | - Chirag Gordhan
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
| | - James K. Liu
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
- Department of Neurological Surgery; Rutgers New Jersey Medical School; Newark NJ
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey; Rutgers New Jersey Medical School; Newark NJ
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey; Rutgers New Jersey Medical School; Newark NJ
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
- Department of Neurological Surgery; Rutgers New Jersey Medical School; Newark NJ
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey; Rutgers New Jersey Medical School; Newark NJ
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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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Chen ZY, Wu B, Yin JL. Intensive chemotherapy failure in Burkitt's lymphoma with cavernous sinus involvement. Med Oncol 2009; 27:327-31. [PMID: 19365738 DOI: 10.1007/s12032-009-9213-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2009] [Accepted: 03/27/2009] [Indexed: 11/24/2022]
Abstract
Burkitt's lymphoma is an aggressive B-cell lymphoma with rapid proliferative index, which makes it disseminate easily to distal sites, especially to bone marrow and the central nerve system. We report here a 22-year-old woman with Burkitt's lymphoma involving multiple organs, including kidneys, breasts, left ovary, and bone marrow at the time of diagnosis. The patient responded well to intensive chemotherapy before the onset of retro-orbital pain, vomiting, and photophobia. The contrast-enhanced T1-weighted image in a second magnetic resonance image (MRI) showed a 2 x 1.9 cm mass in her left cavernous sinus that was not found in her initial MRI. Central nervous system (CNS)-directed high-dose chemotherapy and whole-brain radiation could not change the final failed treatment outcome caused by the cavernous sinus involvement disseminating to her entire CNS. Further study should provide well-designed therapeutic strategies to Burkitt's patients with cavernous sinus involvement.
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Affiliation(s)
- Zhi-Yu Chen
- Department of Medical Oncology, Cancer Hospital, Fudan University, 270 Dong An Road, 200032 Shanghai, China
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Efficacy of Bortezomib followed by local irradiation in two patients with extramedullary plasmacytomas. Leuk Res 2008; 32:839-41. [DOI: 10.1016/j.leukres.2007.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Revised: 09/10/2007] [Accepted: 09/16/2007] [Indexed: 11/21/2022]
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10
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Katodritou E, Speletas M, Pouli A, Tsitouridis J, Zervas K, Terpos E. Successful treatment of extramedullary plasmacytoma of the cavernous sinus using a combination of intermediate dose of thalidomide and dexamethasone. Acta Haematol 2006; 117:20-3. [PMID: 17106187 DOI: 10.1159/000096862] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2006] [Accepted: 04/11/2006] [Indexed: 11/19/2022]
Affiliation(s)
- Eirini Katodritou
- Department of Haematology, Papageorgiou General Hospital, Thessaloniki, Greece
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