1
|
Sato D, Takayanagi S, Takami H, Iwamoto T, Nomura M, Nambu S, Ikemura M, Tanaka S, Saito N. Novel case of primary intracranial solitary plasmacytoma presenting with significant intratumoral hemorrhage. Surg Neurol Int 2022; 13:157. [PMID: 35509594 PMCID: PMC9062931 DOI: 10.25259/sni_66_2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/24/2022] [Indexed: 12/13/2022] Open
Abstract
Background: Solitary plasmacytoma is a localized lesion comprising monoclonal neoplastic proliferation of plasma cells. This disease is rarely encountered and few reports have described primary intracranial solitary plasmacytoma (PISP). Case Description: We report a case of PISP that presented initially as status epilepticus and exhibited massive intratumoral hemorrhage at the subcortical area. To the best of our knowledge, this is the first recorded presentation of this pathology in this manner. Following evacuation of the hematoma and decompressive craniectomy, the patient underwent radiation therapy and showed no sign of tumor recurrence at 3 years after diagnosis. Conclusion: This case reveals that PISP can present as subcortical intraparenchymal hemorrhage. It should be emphasized that the precise diagnosis of this disease is of utmost importance, because solitary plasmacytoma without a background of multiple myeloma responds well to radiation therapy.
Collapse
Affiliation(s)
- Daisuke Sato
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo,
| | | | - Hirokazu Takami
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo,
| | - Tetsuaki Iwamoto
- Department of Neurosurgery, Higashi Yokohama Hospital, Yokohama,
| | - Masashi Nomura
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo,
| | - Shohei Nambu
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo,
| | - Masako Ikemura
- Department of Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | - Shota Tanaka
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo,
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo,
| |
Collapse
|
2
|
Al-Mousa A, Altarawneh M, Alqatawneh O, Bashir Z, Al-Dwairy S, Shtaya A. Eosinophilic Granuloma of the Skull Presenting as Non-Traumatic Extradural Haematoma in Children. Int J Gen Med 2020; 13:1229-1234. [PMID: 33262638 PMCID: PMC7700074 DOI: 10.2147/ijgm.s288512] [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] [Received: 10/24/2020] [Accepted: 11/13/2020] [Indexed: 01/17/2023] Open
Abstract
Cranial extradural haematoma (EDH) is a neurosurgical emergency that can be caused by traumatic or non-traumatic causes with the former being more prevalent. Non-traumatic causes are variable and can include infection, vascular malformation and haematological disorders. This paper will address an extremely rare non-traumatic cause of EDH. More specifically, eosinophilic granuloma (EG), the localized form of Langerhans histiocytosis, may involve the skull and has rarely been reported to present with EDH. The case that will be presented is that of a three-year-old male patient, who presented with progressive vomiting and drowsiness, associated with left parietal swelling. CT scan of the brain showed an extradural haematoma and an osteolytic parietal lesion. He underwent emergent craniectomy, evacuation of the haematoma and dura resection as the lesion was infiltrating the dura. Histopathological examination of the dura and the bone edges showed eosinophilic granuloma (EG). The mechanism of a haemorrhage in this situation is poorly understood and the literature is extremely scarce. In conducting a thorough literature review, only 11 case reports of EG causing non-traumatic EDH were found. The details of these 11 cases will be reviewed and discussed in this paper, in addition to our illustrative case.
Collapse
Affiliation(s)
- Alaa Al-Mousa
- Department of General and Special Surgery, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan.,Department of Surgery, Prince Hamza Hospital, Amman 11732, Jordan
| | | | - Omar Alqatawneh
- Department of Surgery, Prince Hamza Hospital, Amman 11732, Jordan
| | - Zalina Bashir
- Department of Pathology, Prince Hamza Hospital, Amman 11732, Jordan
| | - Salem Al-Dwairy
- Department of General and Special Surgery, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan.,Department of Surgery, Prince Hamza Hospital, Amman 11732, Jordan
| | - Anan Shtaya
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.,Atkinson Morley Neurosurgery Centre, St George's University Hospital NHS Trust, London, UK
| |
Collapse
|
3
|
Erdem MB, Çakmak P, Akyürek N, Dogulu F. Plasmacytoma Masquerading as Meningioma. INDIAN JOURNAL OF NEUROSURGERY 2020. [DOI: 10.1055/s-0040-1716989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
AbstractSolitary bone plasmacytoma is a rare disease in the skull. We present a 70-year-old patient who presented with a skull deformity due to the left parietooccipital tumor. Neurological examination found no deficit. The systemic scanning revealed no additional lesion. The surgery was planned, and the tumor was removed totally with the marginal bone around it. Histopathological examination confirmed solitary bone plasmacytoma. The patient is being followed-up without recurrence or progression to multiple myeloma. As the calvarial solitary bone plasmacytomas can be easily misdiagnosed preoperatively, the detailed examination of the CT features may be helpful for the planning and course of the surgery.
Collapse
Affiliation(s)
- Münibe Büşra Erdem
- Department of Neurosurgery, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Pınar Çakmak
- Department of Medical Pathology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Nalan Akyürek
- Department of Medical Pathology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Fikret Dogulu
- Department of Neurosurgery, Gazi University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
4
|
Solitary Extramedullary Plasmacytoma Mimicking Acute Subdural Hematoma. World Neurosurg 2018; 120:521-524. [DOI: 10.1016/j.wneu.2018.09.151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 11/20/2022]
|
5
|
Intracranial hemorrhage as initial manifestation of plasma cell myeloma: A case report. J Clin Neurosci 2018; 50:133-135. [PMID: 29428262 DOI: 10.1016/j.jocn.2018.01.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/08/2018] [Indexed: 11/23/2022]
Abstract
This is the case of a previously healthy 48 year-old male whom presented with mild confusion, low-grade headache, and left sided weakness. Computed tomography of the head revealed a large acute right frontal lobe intracranial hemorrhage (ICH) and intraventricular extension, with normal vascular imaging. Initial laboratory testing was inconsequential. The patient required emergent evacuation, with pathology revealing only elements of a hematoma. Further laboratory testing and bone marrow biopsy results confirmed the diagnosis of plasma cell myeloma. Other systemic signs/symptoms of this disease were notably absent. This report provides the first description of an ICH as the presenting manifestation of plasma cell myeloma (PCM; multiple myeloma).
Collapse
|
6
|
Lasocki A, Gangatharan S, Gaillard F, Harrison SJ. Intracranial involvement by multiple myeloma. Clin Radiol 2015; 70:890-7. [PMID: 25956664 DOI: 10.1016/j.crad.2015.03.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 02/18/2015] [Accepted: 03/24/2015] [Indexed: 11/19/2022]
Abstract
Intracranial involvement is a rare complication of multiple myeloma. It results either from direct extra-osseous spread from adjacent skeletal plasmacytomas or extra-medullary disease via haematogenous dissemination. The imaging appearances are non-specific, and dural, leptomeningeal, and parenchymal involvement can all occur. The purpose of this review is to illustrate the various neuroimaging appearances of this rare entity, focusing on MRI.
Collapse
Affiliation(s)
- A Lasocki
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; Department of Diagnostic Imaging, Monash Health, Clayton, Victoria, Australia.
| | - S Gangatharan
- Department of Haematology, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - F Gaillard
- Department of Radiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Radiology, The University of Melbourne, Parkville, Victoria, Australia
| | - S J Harrison
- Department of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
7
|
Miles JD, Selman WR, Ahmad SA, Alshekhlee A. Cranial Vault Plasmacytoma Presenting With Hemorrhagic Transient Ischemic Attacks. J Stroke Cerebrovasc Dis 2010; 19:510-1. [DOI: 10.1016/j.jstrokecerebrovasdis.2009.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Revised: 08/31/2009] [Accepted: 09/10/2009] [Indexed: 10/19/2022] Open
|
8
|
Crowley RW, Sansur CA, Sheehan JP, Mandell JW, Kassell NF, Dumont AS. Intracranial plasmacytoma with apoplectic presentation and spontaneous intracerebral hemorrhage: Case report and review of the literature. Clin Neurol Neurosurg 2009; 112:172-5. [PMID: 20031303 DOI: 10.1016/j.clineuro.2009.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Revised: 11/05/2009] [Accepted: 11/06/2009] [Indexed: 11/18/2022]
Abstract
Involvement of the nervous system is not uncommon in patients with multiple myeloma, with polyneuropathy and myelopathy predominating. Intracranial involvement producing neurological symptoms, however, is distinctly uncommon. Massive intraparenchymal hemorrhage from a previously unrecognized intracranial plasmacytoma is exceedingly rare. The authors report the case of a 57-year-old male who presented with sudden onset of severe headache, rapid onset of right-sided weakness and deterioration in level of consciousness while at work. Two years earlier the patient had completed treatment for multiple myeloma and was considered to be in remission, with a recent bone marrow biopsy that was negative, and complete normalization of serum protein electrophoresis. Imaging studies revealed a massive intracerebral hemorrhage with the possibility of an underlying lesion, and the patient was taken for emergent hematoma evacuation and tumor resection. The patient made an excellent recovery and was treated with intracranial radiation. Even in patients with multiple myeloma without evidence of systemic disease following successful treatment, the possibility of unrecognized lesions lingers. The onset of new symptoms referable to potential intracranial pathology in this setting should prompt consideration of intracranial plasmacytoma in the differential diagnosis.
Collapse
Affiliation(s)
- R Webster Crowley
- Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, 22908, United States
| | | | | | | | | | | |
Collapse
|