2019
DOI: 10.1055/s-0039-1697636
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A Large Mass Mimicking Calcified Hematoma of the Skull Showing Involvement of Myeloma Cells and a Good Response to Irradiation

Abstract: Patients with multiple myeloma often show skull bone involvement, although in most cases this is manifested as skull erosion and large masses develop only rarely. Here we report a patient who presented with a large cranial mass mimicking a subdural hematoma with calcification. The tumor shrunk with 37.5 Gy of focal irradiation in 15 fractions after biopsy. After irradiation the patient was treated with Bortezomib but died because of adverse events. The differential diagnosis of lenticular lesion of the skull a… Show more

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Cited by 3 publications
(4 citation statements)
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“…In a report of two cases, there were no symptoms in children and one episode of seizure without a neurological deficit in adults [12]. The differential diagnoses include calcified epidural hematoma, calcified subdural empyema, meningioma, calcified arachnoid cyst [6,7,13], and rarely plasmacytoma or a tumor mass composed of myeloma cells [ 14,15]. One recent report says that the ossified chronic subdural hematoma should be considered a differential diagnosis when encountering an intracranial placeholder [16].…”
Section: Discussionmentioning
confidence: 99%
“…In a report of two cases, there were no symptoms in children and one episode of seizure without a neurological deficit in adults [12]. The differential diagnoses include calcified epidural hematoma, calcified subdural empyema, meningioma, calcified arachnoid cyst [6,7,13], and rarely plasmacytoma or a tumor mass composed of myeloma cells [ 14,15]. One recent report says that the ossified chronic subdural hematoma should be considered a differential diagnosis when encountering an intracranial placeholder [16].…”
Section: Discussionmentioning
confidence: 99%
“…Plasmacytoma incidentally discovered after a head injury is rare. Some head tumors are related to injuries, such as eosinophilic granuloma [6,7] and meningioma [8]. The skull-bone cells may undergo genetic mutation during the process of wound repair, leading to tumors over a long period of time.…”
Section: Discussionmentioning
confidence: 99%
“…If progression to MM occurs, systemic therapy like high-dose chemotherapy and autologous hematopoieticcell transplant may be administered [1]. However, patients may die during conservative treatments like radiotherapy and chemotherapy [8,10,12]. If the lesion causes structural instability or neurologic compromise, surgery may be performed [1].…”
Section: Discussionmentioning
confidence: 99%
“…In the second case, the patient was completely asymptomatic, and MRI noted dura involvement, superior sagittal sinus invasion and cerebellar tonsil displacement [ 3 ]; in our presentation, the mass did not invade the dura or displace brain parenchyma. Although scalp masses have been noted on initial presentation of multiple myeloma, patients typically present with additional symptoms, including gait disturbance [ 4 ], acute weakness, bone pain and confusion [ 5 ]. There was also a case report of incidental discovery after imaging following head trauma [ 6 ].…”
Section: Discussionmentioning
confidence: 99%