Intracranial plasmacytoma as an initial presentation of multiple myeloma

Abstract

<jats:title>Abstract</jats:title><jats:p>Intra-cranial involvement is an uncommon complication of multiple myeloma. We report a 68-year-old woman hospitalized for acute renal failure, vertigo and headache. Magnetic Resonance Imaging (MRI) revealed two and a half and 3cm length cranial lesion, which proved to be plasmacytoma. After complete staging, we retained the diagnosis of immunoglobulin G lambda-type multiple myeloma with intracranial involvement. Cytogenetic analysis of plasma cells detected no change. Currently, she is a regular hemodialysis patient. She is planned to have both systemic therapy with 40mg dexamethasone and cranial radiotherapy. Involvement of the CNS in multiple myeloma is very rare. Diagnosis of multiple myeloma subsequent to initial intrcranial involvement is confined to exceptional cases. Despite aggressive systemic treatments, including autologous stem cell transplantation and local treatments such as cerebral radiotherapy, the prognosis for patients with CNS myeloma is extremely poor. Our unique case implies that physicians should be alert in case of vertigo or headache in cases with acute renal failure.</jats:p>

Vertigem como Manifestação Inaugural de Mieloma Múltiplo

“…Existem ainda outras formas de apresentações não convencionais, incluindo infeções bacterianas recorrentes por hipogamoglobulinemia ou hiperviscosidade sintomáticas com confusão, alterações da visão, cefaleias e vertigem. 3 A vertigem como sintoma inicial de mieloma múltiplo é excecionalmente rara. 4 O envolvimento extramedular ocorre em 7% dos pacientes à apresentação e em 6% no decorrer da doença, geralmente, sobre a forma de plasmocitoma isolado, no tecido conjuntivo adjacente ao esqueleto axial.…”