Differential Diagnosis and Treatment Modality of Parasellar Plasmacytoma: Clinical Series and Literature Review

Gui, Songbai; Li, Chuzhong; Bai, Jiwei; Cao, Lei; Liu, Chunhui; Wang, Xinsheng; Zhang, Yazhou

doi:10.1016/j.wneu.2018.10.183

Cited by 7 publications

(11 citation statements)

References 43 publications

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“…To all the references, sellar plasmacytoma have a greater propensity for cavernous sinus invasion and erosion of the parasellar bone, including the cranial nerve foramina. 1 Light microscopy examination might not always be helpful in the differential diagnosis of a parasellar mass, because the features of poorly differentiated plasma cells sometimes resemble the profile of an atypical pituitary adenoma, and immunohistochemical staining is required for definitive diagnosis of a plasmacytoma, 3 as it happened in our case. Nearly half of the patients in their study initially presented with sellar plasmacytomas and ultimately had a subsequent diagnosis of multiple myeloma at full work-up or on follow-up.…”

Section: Discussionmentioning

confidence: 83%

“…It is unusual to find well preserved anterior pituitary function in cases of pituitary adenoma with extensive sellar fossa and clivus destruction. 3 The size of the tumor also differed from the studies reviewed. The mean was 3.4 cm (ranging from 0.9--3.9 cm, n: 12), 1 while the tumor described was 4.6 cm in its greatest extent.…”

Section: Discussionmentioning

confidence: 94%

“…Another condition that should be considered for differentiation is chordoma. 3 Lee et al, 2 after reviewing 70 cases of sellar plasmacytoma (including 65 cases reported from literature), found the following results: slight predominance in male subjects (57% males vs 43% females), median age of 59 years old, and hyperprolactinemia in 38% of the patients (median level 36.7 ng/mL). The majority of the patients presented with mass effect symptoms, including headaches in 70%, cranial nerve palsies in 65%, and visual disturbances in $ 80%.…”

Section: Discussionmentioning

confidence: 96%

“…2 It is believed that the entity originates from the surrounding mucosa of the sellar region and clivus, which can be locally aggressive. 3 Plasmacytomas are often misdiagnosed as adenomas due to the rarity of this disease and the limited clinical experience of entity in this location. The pathological study shows distinct plasmacytoid features, including prominent nucleoli.…”

Section: Introductionmentioning

confidence: 99%

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Huge Sellar Plasmacytoma as Differential Diagnosis of Invasive Pituitary Adenoma: A Case Report

Filgueira-Junior

Dornelas

Barboza-Filho

et al. 2021

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Sellar plasmacytomas are rare tumors arising from plasma cells. They are often misdiagnosed as adenomas. We report the case of a 63-year-old woman with headache, cranial nerve III palsy and decreased visual acuity. Imaging revealed an extensive lesion centered on the clivus, extending to the cavernous sinus bilaterally and into the sphenoid sinus. The hormonal tests were compatible with panhypopituitarism and mild hyperprolactinemia. The first hypothesis was invasive pituitary adenoma. Partial resection was achieved, and the immunohistochemical evaluation was compatible with plasmacytoma. After a few weeks, she developed lumbar and hip pain, and the imaging confirming osteolytic lesions. The final diagnosis was multiple myeloma.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Huge Sellar Plasmacytoma as Differential Diagnosis of Invasive Pituitary Adenoma: A Case Report

Filgueira-Junior

Dornelas

Barboza-Filho

et al. 2021

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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“…This is a rare presentation of multiple myeloma (MM) with a massive osteolytic lesion at the clivus. Given its availability, brain CT is usually the first imaging modality; however, MRI is fundamental for a better characterization of the MM lesions at the skull base that are typically isointense or hypointense on T1‐weighted MRI, but hyperintense on T2 [ 1 , 2 , 3 , 4 ]. Other differential diagnosis include plasmacytoma, chordoma, osteosarcoma, nasopharyngeal carcinoma, meningioma, metastatic carcinoma, and lymphoma [ 1 , 2 , 3 ].…”

mentioning

confidence: 99%

Multiple myeloma presenting as a massive osteolytic lesion at the clivus

Sousa

Couto

Tavares

et al. 2020

eJHaem

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Enhanced clinical outcomes with radiotherapy in diagnostically challenging intracranial plasmacytomas: Analysis of 190 cases

Feng,

Zhang,

Qiu

et al. 2024

Cancer Medicine

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BackgroundIntracranial plasmacytomas are rare tumors arising from plasma cells with approximately half of the cases progressing to multiple myeloma (MM). However, there is a lack of comprehensive clinical cohort analysis on the clinical and pathological features, progression, and outcomes of intracranial plasmacytomas.MethodsA retrospective analysis of 190 cases was conducted, combining data from 38 cases in a single institution and 152 cases from the literature. Patient demographics, clinical presentations, tumor locations, imaging features, surgical treatments, and follow‐up outcomes were collected and analyzed. Survival analysis and Cox regression analysis were performed to identify prognostic factors.ResultsA total of 190 intracranial plasmacytoma patients with an average age of 55.4 years were included in the study. The preoperative misdiagnosis ratio was high at 55.3%, and 59.7% of the tumors affected the calvaria convexity, compared to 40.3% located at the skull base. Resection and biopsy were achieved in 72.4% and 27.6% patients, respectively. Among them, 34.2% (65/190) of patients were initially diagnosed with MM with intracranial plasmacytoma as their first presentation (MM‐IPFP), while 63.2% (120/190) of patients were diagnosed with solitary intracranial plasmacytoma (SIP), including 61 extramedullary plasmacytomas and 59 solitary bone plasmacytomas. In the SIP group, 22.4% (24/107) of patients experienced disease progression leading to the development of MM during a median follow‐up time of 42.6 months (range 1–230 months). Multivariate analysis unveiled that radiotherapy (HR, 0.05; 95% CI, 0.00–0.87; p = 0.04), not surgery, was a protective prognostic factor for overall survival in MM‐IPFP patients. Comparison between the SIP progression group and non‐progression group revealed a significant difference of Ki‐67 index (non‐progression vs. SIP progression, 8.82% ± 7.03 vs. 16.5% ± 10.5, p < 0.05). AUC analysis determined that a cutoff value of 9.0% was the best predictor of SIP progression, with an area under the curve of 0.712.ConclusionsThis retrospective clinical analysis highlights the potential role of radiotherapy, rather than surgical resection, in improving the outcomes of intracranial plasmacytoma. Additionally, the Ki‐67 index is identified as a valuable marker for predicting disease progression. This would provide some evidence for the paradigm of diagnosis and treatment modalities for intracranial plasmacytomas from the large cohort.

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Differential Diagnosis and Treatment Modality of Parasellar Plasmacytoma: Clinical Series and Literature Review

Cited by 7 publications

References 43 publications

Huge Sellar Plasmacytoma as Differential Diagnosis of Invasive Pituitary Adenoma: A Case Report

Huge Sellar Plasmacytoma as Differential Diagnosis of Invasive Pituitary Adenoma: A Case Report

Multiple myeloma presenting as a massive osteolytic lesion at the clivus

Enhanced clinical outcomes with radiotherapy in diagnostically challenging intracranial plasmacytomas: Analysis of 190 cases

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