Calvarial Plasmacytoma Mimicking Meningioma as the Initial Presentation of Multiple Myeloma

Morgenstern, Peter; Pisapia, David; Ramakrishna, Rohan

doi:10.7759/cureus.1126

Cited by 9 publications

(11 citation statements)

References 10 publications

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“…[3][4][5][6] There are case reports of presentation of dural or cranial plasmacytoma at any time during the course of MM 7,8 or even years after complete remission of MM. 9 In our case, the patient was diagnosed with dural plasmacytoma spreading to the bone with soft tissue extension. Involvement of the dura mater arising from bony lesions in the calvaria, skull bone, and nasal or paranasal Fig.…”

Section: Discussionmentioning

confidence: 73%

Dural Plasmacytoma Involving Calvarium with Soft Tissue Extension Mimicking Meningioma: A Diagnostic Dilemma

Shukla

Chhabra

Pandey

et al. 2019

Indian Journal of Neurosurgery

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Here, the authors describe a case of 25-year-old man diagnosed with dural plasmacytoma involving calvarium with soft tissue extension. Magnetic resonance imaging (MRI) revealed extra-axial heterogeneously enhancing soft tissue mass lesion in the left parieto-occipital region with a dural tail mimicking meningioma, destroying the left parietal bone, and bulging into the scalp. Mass was excised and histopathologic examination revealed plasmacytoma with amyloid deposition. There is no recurrence after postoperative radiotherapy and 2 years of follow-up, although the future course is still not certain. The clinician should consider alternative diagnosis other than meningioma prior to proceeding to surgery if the dural-based lesion is involving calvarium and soft tissue extension.

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Section: Discussionmentioning

confidence: 73%

Dural Plasmacytoma Involving Calvarium with Soft Tissue Extension Mimicking Meningioma: A Diagnostic Dilemma

Shukla

Chhabra

Pandey

et al. 2019

Indian Journal of Neurosurgery

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“…EMPs can be an early presentation of, or progress toward, MM. Intracranial locations of plasmacytoma vary from cranial vault, skull base, sphenoclival, cavernous sinus, to diffuse or focal meningeal involvement [8], [9], [10], [11], [12], [13]. Different locations of dural plasmacytoma such as parafalcine, frontotemporal, spinal, and cerebellopontine have been reported such that clinical presentation can mimic meningioma.…”

Section: Discussionmentioning

confidence: 99%

Multiple myeloma presenting as dural plasmacytoma

Gregorio

Soyemi

2019

Radiology Case Reports

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The finding of intracranial, extramedullary plasmacytoma is rare in multiple myeloma, especially with dural involvement. Meningioma remains the most common intracranial extra-axial mass. We report a case of a 39-year-old male who presented with intracranial, extra-axial mass found later to be dural plasmacytoma and additional multiple lesions on skeletal survey, leading to a diagnosis of multiple myeloma. The objective of this case is to increase awareness of the possibility of dural plasmacytoma as a differential diagnosis of meningioma and a harbinger of multiple myeloma. Magnetic resonance imaging plays a vital role in the detection of additional lesions in individuals while excluding multiple myeloma.

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“…The dural involvement occurs through contiguous route from the adjacent bone or hematogenous spread. [10] One more conundrum in radiology was “non osteolytic” appearance. The hyperosteotic bone misleads us in line of meningioma.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of solitary spinal intradural plasmacytoma: The unforeseen challenge

Singh

Kumar

Bhaisora

et al. 2019

J Craniovert Jun Spine

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Localized proliferation of atypical plasma cells, either at bony or extramedullary, forms a rare subset of multiple myeloma (MM) disorders. The patients usually present with intractable pain and pathological fractures and respond well to radiotherapy. The clinical presentation is variable and radiologically is nonspecific. The spinal location is rare, and the solitary plasmacytoma in the intradural extramedullary (IDEM) region is unusual. Herein, we report the second case of solitary plasmacytoma at the lumbar IDEM region. A 54-year-male patient was referred to our institute with complaints of radicular pain in bilateral lower limbs along L5 dermatome for the past 3 months. The neurological examination was normal with power 5/5 and reflexes 2+, except for bilateral straight leg raising test restricted at 30. Magnetic resonance imaging of spine showed a well-defined eccentrically placed (left Side) spherical lesion at the level of L2 vertebrae. The lesion had foraminal extension and showed minimal contrast enhancement. The underlying ventral vertebral body was irregular and hyperosteotic. Our radiological impression was primarily neurofibroma, but the features were slightly atypical. The patient underwent L1–L2 laminectomy and excision of IDEM tumor. The histopathological features were consistent with plasmacytoma. The histopathology was a surprise to us. We further evaluated the patient for MM. He received adjuvant radiotherapy and is currently asymptomatic. An index of suspicion for SP must be kept among differentials of intradural lesions, especially when adjacent bony changes are present. The diagnosis of plasmacytoma warrants further workup according to the recommendations of the International Myeloma Working Group.

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Calvarial Plasmacytoma Mimicking Meningioma as the Initial Presentation of Multiple Myeloma

Cited by 9 publications

References 10 publications

Dural Plasmacytoma Involving Calvarium with Soft Tissue Extension Mimicking Meningioma: A Diagnostic Dilemma

Dural Plasmacytoma Involving Calvarium with Soft Tissue Extension Mimicking Meningioma: A Diagnostic Dilemma

Multiple myeloma presenting as dural plasmacytoma

An unusual case of solitary spinal intradural plasmacytoma: The unforeseen challenge

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