Dural plasmacytoma mimicking meningioma in a young patient with multiple myeloma

Rahmah, Nn; Brotoarianto, Hk; Andor, E; Kusnarto, Gunadi; Muttaqin, Zainal; Hongo, Kazuhiro

doi:10.2349/biij.5.2.e5

Cited by 14 publications

(21 citation statements)

References 28 publications

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“…In this case, the mass was isointense to gray matter both on T1 and T2 WI. Previous reports of the MR imaging appearance of solitary plasmacytoma of the skull have described a slightly inhomogeneous, expansile mass eroding the bone that is isointense to the brain on noncontrast T1 WI and isointense or slightly hyperintense on T2 WI, (12, 13) which were similar to the findings in our patient. The extraaxial location, sharp margins between the tumor and the brain, signal characteristics and the enhancement pattern of the lesion in our case bore some similarities to meningioma.…”

Section: Discussionsupporting

confidence: 89%

“…The extraaxial location, sharp margins between the tumor and the brain, signal characteristics and the enhancement pattern of the lesion in our case bore some similarities to meningioma. Several studies and case reports have established the imaging similarities between plasmacytoma and meningiomas (12, 14). However, the neuroradiological findings generally lack specificity, since they are generally no different from those of meningioma, metastasis, lymphoma, dural sarcoma, plasma cell granuloma, infectious meningitis and leptomeningeal carcinomatosis (11).…”

Section: Discussionmentioning

confidence: 98%

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Extramedullary Plasmacytoma Presenting as a Solitary Mass in the Intracranial Posterior Fossa

et al. 2012

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A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 98%

Extramedullary Plasmacytoma Presenting as a Solitary Mass in the Intracranial Posterior Fossa

et al. 2012

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“…Cranial nerve palsies, particulary sixth nerve paresis may be initial presenting features of plasmacytoma and multiple myeloma or may manifest in patients on follow up. Although dural infiltration in multiple myeloma is very rare, it may closely resemble meningioma [8]. Local irradiation is the primary mode of treatment for extramedullary plasmacytoma and multiple myeloma, occasionally followed by surgical resection of the residual tumor [9].…”

Section: Discussionmentioning

confidence: 99%

Clivus and Dural Involvement in a Case of Multiple Myeloma: A Rare Complication of Multiple Myeloma

Bhartiya

Pachisia

Kapoor

et al. 2015

Indian J Hematol Blood Transfus

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“…In our case the mass was described as large robustly enhancing extra-axial mass centered along the right parietal calvarium, measuring 5.5x 5 centimeters, with slightly restricted diffusion and mild enhancement of the adjacent dura. In previous studies, plasmacytomas of the skull have been described as slightly inhomogeneous, expansible masses eroding the bone that is isointense to the brain on non-contrast brain CT scans [21,22].…”

Section: Discussionmentioning

confidence: 99%

Parietal Plasmacytoma: An Ominous Sign of Disease Recurrence

Duma¹,

Patel²,

Nasereddin³

2015

AJMCR

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Plasmacytomas located in the central nervous system are rareentities; with no pathognomonic clinical or radiologic features histology is required for a definite diagnosis. We present a case of a dural plasmacytoma as the manifestation of disease recurrence in a patient with systemic multiple myeloma. 51 year old male with history of IgG kappa myeloma, who underwent complete remission after an autologous bone marrow transplant presented to the clinic 10 months post-remission complaining of a "head mass". On physical examination, he was found to have a large soft mass in the parietal area. On MRI the lesion was described as an extra-axial mass, 5.5 cm x5cm diameter, with diffuse enhancement of the dura. Biopsy of the mass revealed anextramedullary plasmacytoma. At that time, his M spike and immunoglobulins levels were unremarkable. Several months after the presentation of the parietal mass, the patient developed recurrence of disease. He underwent a second autologous bone marrow transplant that markedly improved the size of the plasmacytoma. Patient achieved a complete remission after the second transplant. However, 6 months later the dural plasmacytoma increased in size and once again and his myeloma markers remained within normal levels. Unfortunately, recurrence of the multiple myeloma occurred several months later and despite several cycles of chemotherapy, the patient continued to have progression of disease. He then decided for a more conservative treatment and was sent to home hospice. Central nervous system plasmacytomas can present as solitary lesions or as part of systemic multiple myeloma, these tumors tend to have a direct relationship with the activity of the disease and can present as an early sign of recurrence despite normal multiple myeloma markers on peripheral blood. Keywords: dural plasmacytoma, multiple myeloma, solitary plasmacytoma, multiple myeloma recurrenceCite This Article: Narjust Duma MD, Dhruvesh Patel, and Thayer Nasereddin, "Parietal Plasmacytoma: An Ominous Sign of Disease Recurrence." American Journal of Medical Case Reports, vol. 3, no. 6 (2015): 163-166. doi: 10.12691/ajmcr-3-6-4. BackgroundPlasma cell neoplasms can be broadly categorized into multiple myeloma and plasmacytomas. Multiple myeloma, the more common form of plasma cell neoplasms, is composed of abnormal plasma cells that proliferate in the bone marrow. These abnormal cells disrupt normal hematopoiesis, invade adjacent bone and produce paraproteins. Anemia, hypercalcemia, and renal insufficiency are the consequent symptoms of this systemic disease. In contrast to multiple myeloma, plasmacytomas are composed of a mass of neoplastic plasma cells. These masses can be isolated neoplasms with or without the systemic symptoms of multiple myeloma.Plasmacytomas are further subdivided inthree distinct types of plasmacytomas-solitary plasmacytoma of the bone, extramedullary plasmacytoma and multiple plasmacytomas that are either primary or recurrent [1]. Extramedullary plasmacytomas account for 3% of plasma cell neopl...

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Dural plasmacytoma mimicking meningioma in a young patient with multiple myeloma

Cited by 14 publications

References 28 publications

Extramedullary Plasmacytoma Presenting as a Solitary Mass in the Intracranial Posterior Fossa

Extramedullary Plasmacytoma Presenting as a Solitary Mass in the Intracranial Posterior Fossa

Clivus and Dural Involvement in a Case of Multiple Myeloma: A Rare Complication of Multiple Myeloma

Parietal Plasmacytoma: An Ominous Sign of Disease Recurrence

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