Solitary plasmacytoma of the calvarium: a review of clinical and prognostic features

Abstract

Primary craniocerebral plasmacytomas are uncommon they represent only 0.7% of all plasmacytomas. We report one case of solitary plasmacytoma of the skull and discuss the clinical features and prognosis of this tumor. There seems to be no difference in prognosis between plasmacytomas originating from the bone (osseous form) and those originating from the dura mater (non-osseous form). In these lesions, the risk of secondary multiple myeloma appears to be low.

Solitary dural plasmacytoma with parenchymal invasion

“…[5][6][7][8][9][10][11][12] Intracranial plasmacytomas are associated with cranial nerve palsies and clinical manifestation of space-occupying lesions such as headaches, visual problems, seizures, or paresis. [13][14][15][16][17] As in our case, the patient had headache, left hemiparesis, and seizure.…”

Plasmacytoma of the skull mimicking an epidural hematoma

“…[4] Luigi and Maurizio reported that a right fronto-parietal skull plasmacytoma was found on CT; the patient underwent total removal of the tumor by craniotomy was not followed by any chemotherapy or radiotherapy, and never developed systemic neoplastic disease in 3 years. [5] In contrast, Kyle stated that >80% of patients with an apparently solitary plasmacytoma will eventually develop myeloma. [6]…”

“…Patients with solitary skull plasmacytomas often present with several months of slight headaches [5,7] or hearing disturbances, [8] while some patients might have no symptoms at all. Nguyen and Patel noted that a plasmacytoma in one patient was found by her hairdresser.…”

“…On magnetic resonance imaging, the tumor was isointense relative to the brain and enhanced on T1-weighted imaging. [5,7,9] Unlike multiple myeloma, solitary skull plasmacytomas may not have serum M protein or Bence Jones light chains in the urine. [3,5,7,9] The diagnosis is usually made after pathologic tissue is obtained after surgery.…”