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Nazarovs J, Lapse D, Stūre G, Soloveičika M, Jaunozolina L, Ozoliņa E, Lejniece S. Intracerebral Plasmacytoma in a Patient with HIV-1 Infection and SARS-CoV-2 Superinfection. Brain Sci 2022; 12:brainsci12060705. [PMID: 35741591 PMCID: PMC9220964 DOI: 10.3390/brainsci12060705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/12/2022] [Accepted: 05/25/2022] [Indexed: 02/05/2023] Open
Abstract
We present a rare case of intracranial solitary plasmacytoma arising in brain parenchyma in the basal nuclei. Clinical management and autopsy results of the case are described. Background: Intracranial plasmacytomas arising from brain parenchyma are extremely rare, and data from the literature are limited. Primary intracranial plasmacytomas are rare because plasma cells are not found in the brain in normal conditions. Commonly, intracranial plasmacytoma is associated with multiple myeloma, which is why multiple myeloma must be ruled out to diagnose solitary intracranial plasmacytoma. Considering that solitary plasmacytoma and multiple myeloma have some histopathological similarities, it is important to differentiate them because their respective treatments and prognoses are different. Imaging features of primary extramedullary plasmacytoma are nonspecific but are compatible with solid tumors with invariable enhancement. Plasmacytoma was aggressive because it was not diagnosed after the first MRI, but 1.5 months later, MRI showed a large object. We present a rare case of intracranial solitary plasmacytoma arising in brain parenchyma in the basal nuclei.
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Affiliation(s)
- Jurijs Nazarovs
- Pathology Centre, Riga East Clinical University Hospital, Hipokrāta Street 2, LV-1038 Rīga, Latvia; (D.L.); (L.J.); (E.O.)
- Pathology Institute, Pauls Stradins Clinical University Hospital, Pilsoņu Street 13, LV-1002 Rīga, Latvia
- Department of Pathology, Riga Stradins University, Dzirciema Street 16, LV-1007 Rīga, Latvia
- Correspondence: ; Tel.: +371-29978770
| | - Daira Lapse
- Pathology Centre, Riga East Clinical University Hospital, Hipokrāta Street 2, LV-1038 Rīga, Latvia; (D.L.); (L.J.); (E.O.)
- Pathology Institute, Pauls Stradins Clinical University Hospital, Pilsoņu Street 13, LV-1002 Rīga, Latvia
| | - Gunta Stūre
- Latvian Centre of Infectious Diseases, Riga East Clinical University Hospital, Linezera, LV-1002 Rīga, Latvia;
- Department of Infectious Diseases, Riga Stradins University, Dzirciema Street 16, LV-1007 Rīga, Latvia
| | - Marina Soloveičika
- Department of Laboratory, Riga East Clinical University Hospital, Hipokrata Street 2, LV-1038 Rīga, Latvia;
| | - Līga Jaunozolina
- Pathology Centre, Riga East Clinical University Hospital, Hipokrāta Street 2, LV-1038 Rīga, Latvia; (D.L.); (L.J.); (E.O.)
- Department of Radiology, Riga Stradins University, Dzirciema Street 16, LV-1007 Rīga, Latvia
| | - Elīna Ozoliņa
- Pathology Centre, Riga East Clinical University Hospital, Hipokrāta Street 2, LV-1038 Rīga, Latvia; (D.L.); (L.J.); (E.O.)
| | - Sandra Lejniece
- Hematology and Chemotherapy Clinic, Riga East Clinical University Hospital, Hipokrāta Street 2, LV-1038 Rīga, Latvia;
- Department of Internal Diseases, Riga Stradins University, Dzirciema Street 16, LV-1007 Rīga, Latvia
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2
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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.
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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,
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3
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Bin Waqar SH, Rehan A, Salahi N, Zhonghua L, McFarlane I. An Exceptional Case of Diplopia and Ptosis: Extramedullary Plasmacytoma of the Clivus With Multiple Myeloma. Cureus 2022; 14:e23219. [PMID: 35308186 PMCID: PMC8926082 DOI: 10.7759/cureus.23219] [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: 03/16/2022] [Indexed: 11/12/2022] Open
Abstract
Intracranial plasmacytoma is an exceedingly rare presentation of plasma cell neoplasms. Usually presenting late in the course of the disease, progression from the presentation can be abrupt. Hence, a low threshold to biopsy the lesion should be maintained during diagnostic evaluation. Multiple myeloma workup should also be sent and treated concomitantly along with local treatment. Here, we present a case of extramedullary plasmacytoma of the clivus leading to progressive visual deficits with undiagnosed multiple myeloma requiring pulse steroids, intracranial irradiation, and high-dose chemotherapy with improvement in symptoms.
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Gajaria PK, Shenoy AS, Chaudhari JP, Goel NA. Solitary Plasmacytoma with Amyloid - An Unusual Dural-Based Lesion. Asian J Neurosurg 2020; 15:997-1002. [PMID: 33708676 PMCID: PMC7869272 DOI: 10.4103/ajns.ajns_184_20] [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: 04/29/2020] [Revised: 07/19/2020] [Accepted: 09/24/2020] [Indexed: 11/04/2022] Open
Abstract
Solitary plasmacytoma of the dura without systemic involvement are extremely rare lesions, with <15 cases reported in the literature. Among these, ours is the second case to show the presence of amyloid. Fifty-year-old male had presented with headache, sudden onset right-sided weakness, and vomiting. Magnetic resonance imaging revealed an extra-axial mass in the left fronto-parietal region measuring 10 cm × 8.7 cm × 3.9 cm, suggestive of meningioma. The left fronto-parietal craniotomy was performed and multiple tissue bits aggregating to 10 cm × 8.5 cm × 2 cm along with thinned out membrane-like bit of calvarium was sent for pathologic examination. H and E stained sections showed sheets of plasmacytoid cells along with amyloid, which showed apple-green birefringence on Congo red staining. On immunohistochemistry, tumor cells were positive for CD38, CD138, showed kappa light chain restriction and were negative for CD45, CD34. Hence, it was diagnosed as a plasma cell neoplasm. Further work-up with whole-body positron-emission tomography scan revealed no systemic involvement. Dural-based lesions can mimic meningioma radiographically as well as intraoperatively. Histopathological examination unveils the diagnosis, to guide appropriate therapeutic regimens.
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Affiliation(s)
- Pooja Kamlesh Gajaria
- Department of Pathology, Seth G S Medical College, KEM Hospital, Mumbai, Maharashtra, India
| | - Asha Sharad Shenoy
- Department of Pathology, Seth G S Medical College, KEM Hospital, Mumbai, Maharashtra, India
| | | | - Naina Atul Goel
- Department of Pathology, Seth G S Medical College, KEM Hospital, Mumbai, Maharashtra, India
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5
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Peker BC, Ataızı ZS, Ozbek Z. Solitary Plasmacytoma of the Frontal Bone. J Korean Neurosurg Soc 2020; 64:316. [PMID: 33108859 PMCID: PMC7969047 DOI: 10.3340/jkns.2015.0105.001] [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: 05/27/2015] [Accepted: 09/10/2016] [Indexed: 11/27/2022] Open
Abstract
Extramedullary plasmacytoma and solitary plasmacytoma are localized neoplasms. Solitary plasmacytoma of bone consists about 4% of malignant plasma cell tumors. A plasmacytoma involving the frontal bone is unusual, and a limited number of cases have been reported. We present a rare case of a solitary plasmacytoma of the frontal bone manifesting as a forehead lump.
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Affiliation(s)
| | - Zeki Serdar Ataızı
- Department of Neurosurgery, Yunus Emre State Hospital, Eskişehir, Turkey
| | - Zühtü Ozbek
- Department of Neurosurgery, Eskisehir Osmangazi University, Faculty of Medicine, Eskişehir, Turkey
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Primary Plasmacytoma in the Cerebellum: A Case Report and Literature Review. World Neurosurg 2019; 134:10-13. [PMID: 31629133 DOI: 10.1016/j.wneu.2019.10.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Most plasmacytomas arise in the bone marrow (intramedullary), as part of multiple myeloma (MM). In contrast, extramedullary plasmacytoma without MM is rare, and plasmacytoma primarily occurring in the brain parenchyma is extremely rare. Clinical behaviors of primary plasmacytoma in the brain have remained unclear. We report a case of primary plasmacytoma in the cerebellum and review the literature. CASE DESCRIPTION The patient was a 33-year-old woman, displaying vertigo and peripheral facial nerve palsy. A tumor was identified in the subcortical white matter of the middle-upper cerebellum. Magnetic resonance imaging showed no specific findings for this lesion. Tumor was surgically resected because of aggressive tumor growth. Pathologic diagnosis of the tumor was plasmacytoma. The patient was treated with irradiation to the tumor bed after surgery. Although histology of the bone marrow showed a few atypical plasma cells (1%-2%), below the threshold of the diagnostic criterion for MM, we started chemotherapy to prevent occurrence of MM. Neither tumor recurrence nor development of MM was found for 16 months after surgery. CONCLUSIONS Histology is essential for diagnosis of primary plasmacytoma in the brain because of the lack of specific findings on neuroimaging. A finding of a few atypical plasma cells in the bone marrow might support the assumption that extramedullary plasmacytoma represents a harbinger of subsequent development of MM. In addition to appropriate therapies combining maximum tumor removal and radiotherapy to the brain, rigorous hematological management might have contributed to favorable outcomes.
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7
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Clinical features, radiological profiles, and surgical outcomes of primary intracranial solitary plasmacytomas: a report of 17 cases and a pooled analysis of individual patient data. J Neurooncol 2019; 142:263-272. [PMID: 30617445 DOI: 10.1007/s11060-019-03089-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE We aim to delineate the clinical characteristics of patients with primary intracranial solitary plasmacytoma (PISPC) and prognostic factors for their outcomes. METHODS This study retrospectively reviewed 17 patients with PISPC from our center and an additional 70 cases of PISPC published previously to analyze outcome predictors. RESULTS The entire cohort included 38 (43.7%) males and 49 (56.3%) females with a mean age of 54 years. Skull base tumors were found in 49 (56.3%) patients. Gross total resection (GTR) was achieved in 31 (35.6%) patients. Postoperative adjuvant treatments, including radiotherapy (RT) alone, chemotherapy (CMT) alone, and RT + CMT were administered in 49 (56.3%) patients, 3 (3.5%) patients, and 16 (18.4%) patients, respectively. After a median follow-up of 24 (mean 42.4) months, the 5-year disease progression-free survival (PFS), recurrence-free survival (RFS), multiple myeloma (MM)-free survival (MMFS), and overall survival (OS) were 52.9%, 76.2%, 69.6%, and 76.1%, respectively. Multivariate analysis unveiled that a skull base tumor location (HR 2.395, p = 0.040) and no RT (HR 3.115, p = 0.004) were negative prognostic factors for PFS, no RT (HR 10.526, p = 0.003) for RFS, each 1-year increase in age (HR 1.039, p = 0.049) for MMFS, and increasing age (HR 1.052, p = 0.043) and CMT (HR 6.022, p = 0.005) were risk factors for OS. However, GTR did not benefit the aforementioned outcomes. CONCLUSION For patients with presumed PISPC, a biopsy followed by RT is recommended for skull base PISPC. However, the role of CMT is still not clear. Our findings need to be verified in a larger prospective cohort in the future. Systematic review registration number CRD42018098782.
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8
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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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9
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Ferrari S, Tecchio C, Turri G, Richelli S, Ghimenton C, Monaco S, Todeschini G. Unusual case of solitary intraparenchymal brain plasmacytoma. J Clin Oncol 2012; 30:e350-2. [PMID: 23032627 DOI: 10.1200/jco.2012.43.0215] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sergio Ferrari
- University of Verona, Azienda Ospedaliera-Univesitaria Integrata, Verona, Italy
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10
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Liu ZY, Qi XQ, Wu XJ, Luo C, Lu YC. Solitary Intracranial Plasmacytoma Located in the Spheno-Clival Region Mimicking Chordoma: A Case Report. J Int Med Res 2010; 38:1868-75. [PMID: 21309504 DOI: 10.1177/147323001003800535] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Solitary intracranial plasmacytoma (SIP) is very rare. This case report presents serial findings of SIP located in the spheno-clival region in a 54-year old female who presented with an inferior hemianopia in the right eye and an enlarged physiological blind spot in both eyes. Based on the initial diagnosis of a spheno-clival region chordoma, the tumour was partially resected by the nasal–sphenoidal sinus approach. Subsequently, the correct diagnosis of SIP was made based on the pathology and immunohistochemical staining of the tumour. The patient was treated using a whole skull-base radiation therapy protocol with 45 Gy and she was in good physical condition during the subsequent 22 months. The findings of a series of similar case reports documenting SIP in 20 cases published from 1976 to 2008 are also reviewed. Based on these case reports, the key features of SIP, including their clinical manifestations, clinical imaging characteristics, treatment and prognosis, are described.
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Affiliation(s)
- ZY Liu
- Department of Neurosurgery, Chang Zheng Hospital, Second Military Medical University, Shanghai, China
| | - XQ Qi
- Department of Neurosurgery, Chang Zheng Hospital, Second Military Medical University, Shanghai, China
| | - XJ Wu
- Department of Neurosurgery, Chang Zheng Hospital, Second Military Medical University, Shanghai, China
| | - C Luo
- Department of Neurosurgery, Chang Zheng Hospital, Second Military Medical University, Shanghai, China
| | - YC Lu
- Department of Neurosurgery, Chang Zheng Hospital, Second Military Medical University, Shanghai, China
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11
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Cao X, Luan S, Sun L, Yang B, Shen C, Bao W. Impaired vision associated with a solitary intracranial plasmacytoma. J Clin Neurosci 2010; 17:1215-7. [PMID: 20570518 DOI: 10.1016/j.jocn.2009.12.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 12/22/2009] [Accepted: 12/29/2009] [Indexed: 11/24/2022]
Abstract
Solitary intracranial plasmacytomas (SICPs) are extremely uncommon tumors in the central nervous system, and are often misdiagnosed pre-operatively. We report a patient with SICP, describe the neuroradiological and neurosurgical features and the clinical management of this patient, and review the pertinent literature.
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Affiliation(s)
- Xiaoyun Cao
- Department of Neurosurgery, Huashan Hospital of Fudan University, 12 Middle Wulumuqi Road, Shanghai 200040, China
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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.
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Affiliation(s)
- R Webster Crowley
- Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, 22908, United States
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13
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Pontikoglou C, Fragos C, Kolyvaki E, Samonis G, Eliopoulos GD, Papadaki HA. Multiple myeloma involving the central nervous system: a report of two cases with unusual manifestations. Leuk Lymphoma 2009; 46:737-41. [PMID: 16019512 DOI: 10.1080/10428190500032661] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We describe two patients with multiple myeloma (MM) involving the central nervous system (CNS). In both patients, CNS involvement was manifested with extremely rare signs and symptoms. The first patient, a 64-year-old woman, developed obstructive hydrocephalus 10 years after the initial diagnosis of MM. The disease has been successfully treated with intrathecal chemotherapy, radiotherapy and systemic chemotherapy. The other patient, a 65-year-old man, developed hypopituitarism and diabetes insipidus 1 year after MM diagnosis. Disease in this patient proved resistant to both radiotherapy and chemotherapy; the patient died 2 years later. These rare complications add new information on the wide spectrum of clinical and laboratory manifestations of MM. It is obvious that descriptions of additional cases are required to better understand the mechanisms of CNS involvement in MM patients.
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Affiliation(s)
- Charalampos Pontikoglou
- Department of Hematology, University of Crete School of Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece
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14
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Van Wettere AJ, Linder KE, Suter SE, Olby NJ. Solitary Intracerebral Plasmacytoma in a Dog: Microscopic, Immunohistochemical, and Molecular Features. Vet Pathol 2009; 46:949-51. [DOI: 10.1354/vp.08-vp-0012-v-bc] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A primary intracerebral plasmacytoma was identified in a 7-year-old spayed female Boston Terrier. Grossly, a well-demarcated, 2 cm in diameter, roughly spherical tumor was in the rostral aspect of the left cerebral hemisphere. Histologically, the neoplasm was composed of sheets of round cells with distinct plasmacytoid features and marked anisocytosis and anisokaryosis. Cells were positive for vimentin, CD18, CD79a, and lambda light-chain, and negative for kappa light chain, cytokeratin, lysozyme, glial fibrillary acidic protein, and S100 protein. Clonally rearranged B-cell antigen receptor genes were detected by PARR (polymerase chain reaction for antigen receptor rearrangements), confirming clonal proliferation of B lymphocytes. Although primary solitary intracerebral plasmacytoma is rare in dogs and other species, it should be included in the differential diagnosis for central nervous system round-cell neoplasms. Clonality testing can be utilized to support the histological diagnosis of this neoplasm type.
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Affiliation(s)
- A. J. Van Wettere
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606
| | - K. E. Linder
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606
| | - S. E. Suter
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606
| | - N. J. Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606
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15
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Zazpe I, Caballero C, Cabada T, Guerrero D, Gallo-Ruiz A, Portillo E. Solitary thoracic intradural extramedullary plasmacytoma. Acta Neurochir (Wien) 2007; 149:529-32; discussion 532. [PMID: 17404683 DOI: 10.1007/s00701-007-1138-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Accepted: 02/21/2007] [Indexed: 10/23/2022]
Abstract
The bodies of the vertebrae are common locations for plasma cell diseases such as multiple myeloma and solitary plasmacytoma. Secondary invasion of the epidural space is infrequent but can cause neurological symptoms. Spinal cord compression due to pure intradural plasma cell infiltration is very rare. The authors report a 25-year-old woman who developed a progressive difficulty in walking due to a solitary spinal dural plasmacytoma. This is the first reported example in the English language literature of a purely intradural spinal plasmacytoma in a patient without other myelomatous lesions. An entirely intradural solitary plasmacytoma has a relatively better prognosis.
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Affiliation(s)
- I Zazpe
- Department of Neurosurgery, Hospital of Navarre, Pamplona, Spain.
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16
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Viehöver A, Hähnel S, Weber MA, Zoubaa S, Wildemann B. Atypische monoklonale Plasmazellhyperplasie. DER NERVENARZT 2006; 77:1495-500. [PMID: 17146672 DOI: 10.1007/s00115-006-2223-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Atypical monoclonal plasma cell hyperplasia is extremely rare in the central nervous system without involvement of bone or other systemic disease. This neuropathological entity was first described by Weidenheim and colleagues in 1989. It is considered an inflammatory pseudotumor that can evolve into malignant myeloma. We report on an atypical monoclonal plasma cell hyperplasia with bilateral occipital and cerebellar involvement in a 38-year-old woman. The diagnosis was confirmed by brain biopsy immunohistochemical and molecular tests.
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Affiliation(s)
- A Viehöver
- Abteilung Neurologie, Neurologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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17
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Sahin F, Saydam G, Ertan Y, Calli C, Dönmez A, Tombuloglu M. Dural plasmacytoma mimicking meningioma in a patient with multiple myeloma. J Clin Neurosci 2006; 13:259-61. [PMID: 16459088 DOI: 10.1016/j.jocn.2005.03.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2004] [Accepted: 03/04/2005] [Indexed: 11/21/2022]
Abstract
Apart from calvarial infiltration, intracranial involvement in multiple myeloma is uncommon. Diffuse leptomeningeal invasion with or without parenchymal involvement is most common. Dural infiltration without involvement of the parenchyma, leptomeninges or skull is rare. The differential diagnosis of a dural plasmacytoma includes meningioma, which has a similar MRI appearance, metastasis, lymphoma and sarcoma of the dura mater. We present a patient with multiple myeloma presenting with an intracerebral mass mimicking a meningioma on MRI. Multiple myeloma had been diagnosed seven years previously. The patient presented with headache and speech disturbance 12 months after autologous peripheral stem cell transplantation for recurrence of multiple myeloma. MRI revealed a left temporal extra-axial mass with a dural tail mimicking meningioma. Histopathological examination of the mass after excision showed multiple myeloma immunopositive for IgG, kappa light chain and CD38. There was no recurrence after postoperative radiotherapy. Plasmacytoma should be considered in the differential diagnosis of a solitary dural mass, particularly in a patient with multiple myeloma.
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Affiliation(s)
- Fahri Sahin
- Department of Hematology, Ege University School of Medicine, Bornova 35100, Izmir, Turkey.
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Bazarbacha HM, Jeribi R, Zidi MT, Soukri I, Sebaï R, Belghith L, Touibi S. [Plasmocytoma of the skull base revealing multiple myeloma]. JOURNAL DE RADIOLOGIE 2005; 86:1810-2. [PMID: 16333233 DOI: 10.1016/s0221-0363(05)81528-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We report a case of sphenoidal plasmocytoma in a 57-year-old male revealing multiple myeloma. MRI showed a tumor located in the sphenoid sinus with local extension. Diagnosis was made by histology after transsphenoidal resection. We discuss the imaging features of plasmocytomas and review the principal differential diagnoses.
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Greenberg MJ, Schatzberg SJ, deLahunta A, Stokol T, Summers BA. Intracerebral Plasma Cell Tumor in a Cat: A Case Report and Literature Review. J Vet Intern Med 2004. [DOI: 10.1111/j.1939-1676.2004.tb02589.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Cakir E, Karaarslan G, Usul H, Baykal S, Arslan E. Solitary plasmacytoma with intracranial intraorbital and, paranasal sinus extension. J Clin Neurosci 2003; 10:266-8. [PMID: 12637071 DOI: 10.1016/s0967-5868(02)00283-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Intracranial solitary plasmacytomas (ICSPs) are extremely rare tumours in neurosurgical practice, and are often misdiagnosed preoperatively. Here we present a solitary intracranial plasmacytoma with orbital, nasal and paranasal sinus extension. A subtotal excision of the tumour was performed and the complete response was seen after postoperative radio-chemotherapy. The neuroradiological and neurosurgical features of the case are discussed with the pertinent literature.
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Affiliation(s)
- Ertugrul Cakir
- Department of Neurosurgery, School of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey.
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Vande Broek I, Stadnik T, Meurs A, Maes J, Van Camp B, Schots R. Extramedullary plasmacytoma of the cavernous sinus. Leuk Lymphoma 2002; 43:1691-3. [PMID: 12400615 DOI: 10.1080/1042819021000003054] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We present the case of an 80-year-old male with an history of multiple myeloma (MM) stage I with extramedullary plasmacytoma of the neck, diagnosed 18 months before and in complete remission after radiation therapy and melphalan-prednisone therapy. He was admitted with signs and symptoms characteristic for cavernous sinus syndrome, including diplopia, exophthalmia, ptosis and orbital pain. Magnetic resonance imaging showed a mass lesion in the cavernous sinus, consistent with relapsing extramedullary plasmacytoma. The patient received palliative radiation therapy and high dose dexamethasone, but treatment failed and the patient died. This case represents one of the few reports of extramedullary plasmacytoma of the cavernous sinus. The development of a clinical presentation of cavernous sinus syndrome in a patient with a history of MM or extramedullary plasmacytoma should raise the suspicion of a plasmacytic involvement of the cavernous sinus.
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Affiliation(s)
- I Vande Broek
- Department of Medical Oncology and Hematology, Academic Hospital, Free University Brussels (VUB), Belgium.
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Schwartz TH, Rhiew R, Isaacson SR, Orazi A, Bruce JN. Association between intracranial plasmacytoma and multiple myeloma: clinicopathological outcome study. Neurosurgery 2001; 49:1039-44; discussion 1044-5. [PMID: 11846895 DOI: 10.1097/00006123-200111000-00002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2001] [Accepted: 06/29/2001] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Intracranial plasmacytomas are rare lesions that can arise from the calvarium, dura, or cranial base and exhibit a benign course unless associated with myeloma. Attention has recently been focused on the role of the cell adhesion molecules CD56 and CD31 in the pathogenesis of myeloma. No such information is available for intracranial plasmacytomas and myeloma-associated lesions. METHODS We investigated the relationship between CD56 and CD31 expression, intracranial location, and progression to myeloma for a series of nine intracranial plasmacytomas (three dural, one calvarial, and five cranial base lesions). These parameters were also correlated with proliferation indices, as assessed by MIB-1 immunostaining of the histological sections. A single pathologist (AO) performed immunohistochemical analyses and reviewed all slides. RESULTS Intracranial plasmacytomas presented more commonly in female patients (89%). The three dural lesions were CD56- and CD31-negative and exhibited MIB-1 staining of less than 10%; no patient developed myeloma or recurrence. Of the five cranial base lesions, three were CD56-positive, none was CD31-positive, and two exhibited MIB-1 labeling of more than 45%, with plasmablastic morphological features. Compared with other intracranial plasmacytomas, five of five patients with cranial base lesions developed bone marrow biopsy-proven myeloma (P < 0.05) within 8 months. The calvarial lesion was CD56- and CD31-positive, and the patient developed myeloma soon after diagnosis. Both of the two highly proliferative plasmablastic lesions recurred, one after gross total resection without radiotherapy and the other after a biopsy and 2000-cGy radiotherapy. CONCLUSION Among intracranial plasmacytomas, cranial base location was the strongest predictor of the development of multiple myeloma. Expression of the cell adhesion molecules CD31 and CD56 was not predictive of outcome. Extramedullary dural-based lesions were CD56-negative and were not associated with myeloma. A high proliferation index and plasmablastic morphological features were predictive of a short time to recurrence and aggressive behavior. We recommend 4050- to 5040-cGy fractionated radiotherapy for all intracranial plasma cell neoplasms and gross total resection for non-cranial base lesions.
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Affiliation(s)
- T H Schwartz
- Department of Neurosurgery, Weill Medical College of Cornell University, New York Presbyterian Hospital, 525 East 68th Street, New York, NY 10021, USA.
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Schwartz TH, Rhiew R, Isaacson SR, Orazi A, Bruce JN. Association between Intracranial Plasmacytoma and Multiple Myeloma: Clinicopathological Outcome Study. Neurosurgery 2001. [DOI: 10.1227/00006123-200111000-00002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Molina O, Liscano P, Dorfman S, Cardozo D, Cardozo J. Plasmocitoma solitario extramedular (extraóseo) intracraneal: descripción de un nuevo caso y revisión de la literatura. Neurocirugia (Astur) 2000. [DOI: 10.1016/s1130-1473(00)70739-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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