Cranial Plasmacytoma: A Case Series and Review of the Literature

Abstract

Plasmacytomas are malignant proliferations of plasma cells which can occur with different plasma cell dyscrasias. Solitary plasmacytomas of bone or extraosseous plasmacytomas, depending on the tissue of origin, develop in isolation without systemic manifestations of multiple myeloma. Three cases of cranial plasmacytomas are described, two in patients with multiple myeloma and one extraosseous plasmacytoma. Management options are discussed.

Solitary bone plasmacytoma as posterior fossa cranial neoplasia, presentation of two clinical cases

“…Favorable response to radiotherapy is usually over 80%. [2,9] A R0 resection seems decisive in the presented cases. Even though both patients received postoperative radiotherapy, relapse was documented during follow-up of the patient with subtotal resection.…”

“…After a bibliographical review of surgical resection of plasmacytomas, we found in an article from Na'ara et al A progression to MM from SBP has been established, thus chemotherapy should be initiated in patients in which this progression is documented. [2,9] During follow-up consultations of the presented patients, there was no progression to MM. Prognosis for SBP and EMP is better compared to MM.…”

“…e headache was accompanied with gait lateropulsion, right peripheral facial palsy, and right hemifacial electric shocklike pain, as well as paresthesia. On initial head MRI, there was a posterior fossa tumor, which extended from the right petroclival fissure to the occipital squama, of approximately 88 × 51 × 40 mm, with irregular borders, isointense in T1weighted images and hypointense in T2-weighted images, Table 1: Diagnostic criteria of the International Myeloma Working Group (adapted from reference [4,9] ). with homogenous enhancement on contrast-enhanced images, it caused descending compression of the cerebellar right hemisphere and encased the exiting roots of cranial nerves V, VII-VIII.…”

“…[4] ere are two known clinical presentations: (a) solitary bone plasmacytoma (SBP), which affects of frequency: spine, ribs, skull, and pelvis and (b) soft tissue ("extraosseous" or "extramedullary") (EMP), mostly found in the upper respiratory tract. To diagnose plasma cell dyscrasias, the International Myeloma Working Group [9] criteria are used; these are summarized in [Table 1].…”

Calvarial Plasmacytoma Mimicking Meningioma as the Initial Presentation of Multiple Myeloma

“…However, the appropriate management of plasmacytomas associated with multiple myeloma is less definitive. Most authors suggest chemotherapy with radiation as the first line for these lesions, even when there is a mass effect, because of their exquisite sensitivity to this approach [ 9 - 10 ]. Surgical resection is typically reserved for those refractory to therapy or unable to receive radiation due to proximity to sensitive structures such as the optic chiasm.…”