Imaging of extraosseous intracranial and intraspinal multiple myeloma, including central nervous system involvement

Shpilberg, Katya A.; Esses, Steven J.; Fowkes, Mary; Chari, Ajai; Sacher, Michael; Naidich, Thomas P.

doi:10.1016/j.clinimag.2014.11.017

Cited by 14 publications

(13 citation statements)

References 15 publications

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“…Due to the absence of typical clinical symptoms, a diagnosis of extramedullary plasmacytoma may be missed. Median interval from the diagnosis of MM to detection of CNS myeloma is 6–18 months . But in our study, the interval was < 4 months with both of the two patients.…”

Section: Discussioncontrasting

confidence: 70%

Cerebrospinal Fluid Cytological Diagnosis in Multiple Myeloma With Leptomeningeal Involvement

Ren

Zou

Zhao

et al. 2016

Diagnostic Cytopathology

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Multiple myeloma (MM) with central nervous system (CNS) infiltration is uncommon and the diagnosis is more complicated than that of MM. Here we report two cases of CNS MM that was diagnosed by cerebrospinal fluid cytology examination. Cerebrospinal fluid cytology examination can help to detect malignant cells and immunocytochemistry stain is of great value in identifying an unknown tumor. Diagn. Cytopathol. 2017;45:66-68. © 2016 Wiley Periodicals, Inc.

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Section: Discussioncontrasting

confidence: 70%

Cerebrospinal Fluid Cytological Diagnosis in Multiple Myeloma With Leptomeningeal Involvement

Ren

Zou

Zhao

et al. 2016

Diagnostic Cytopathology

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“…Detection of CNS MM on imaging studies can be challenging. The presence of mass and/or infiltration might be insufficient for establishing the diagnosis of CNS MM . Contrast‐enhanced MRI is more sensitive than CT and constitutes the method of choice in the detection of CNS MM ; however, it is associated with a false negative rate of 10% .…”

Section: Discussionmentioning

confidence: 99%

Central nervous system involvement by multiple myeloma: A multi‐institutional retrospective study of 172 patients in daily clinical practice

et al. 2016

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The multicenter retrospective study conducted in 38 centers from 20 countries including 172 adult patients with CNS MM aimed to describe the clinical and pathological characteristics and outcomes of patients with multiple myeloma (MM) involving the central nervous system (CNS). Univariate and multivariate analyses were performed to identify prognostic factors for survival. The median time from MM diagnosis to CNS MM diagnosis was 3 years. Thirty-eight patients (22%) were diagnosed with CNS involvement at the time of initial MM diagnosis and 134 (78%) at relapse/progression. Upon diagnosis of CNS MM, 97% patients received initial therapy for CNS disease, of which 76% received systemic therapy, 36% radiotherapy and 32% intrathecal therapy. After a median follow-up of 3.5 years, the median overall survival (OS) from the onset of CNS involvement for the entire group was 7 months. Untreated and treated patients had median OS of 2 and 8 months, respectively (p<0.001). At least one previous line of therapy for MM before the diagnosis of CNS disease and >1 cytogenetic abnormality detected by FISH were independently associated with worse OS. The median OS for patients with 0, 1 and 2 of these risk factors were 25 months, 5.5 months and 2 months, respectively (p<0.001). Neurological manifestations, not considered chemotherapy-related, observed at any time after initial diagnosis of MM should raise a suspicion of CNS involvement. Although prognosis is generally poor, the survival of previously untreated patients and patients with favorable cytogenetic profile might be prolonged due to systemic treatment and/or radiotherapy.

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“…Multipl miyelom ile santral sinir sistemi tutulumu nadirdir ve yaklaşık %1 civarında bildirilmiştir (9). Metabolik ensefalopati, kraniyal sinir felçleri, spinal kord kompresyonu, spinal radikülopatiler, monoklonal gamapatiye bağlı periferal nöropatiler şeklinde klinik sunumu olabilir (10).…”

Section: Discussionunclassified

Cavenous Involvement in a Paint with Multiple Myeloma

Yıldız¹,

Tunçel²,

Yurttutan³

et al. 2018

atfm

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Multipl miyelom plazma hücrelerinin neoplastik proliferasyonuyla seyreden sistemik bir hastalıktır (1). Multipl miyelomun ekstramedüller tutulumu nadirdir ve sadece hastaların %3-5'inde görülür. Genellikle deri, nazofarinks, larinks, üst solunum yolu ve merkezi sinir sistemi (MSS) etkilenir. MSS tutulumu, hastaların tahminen %1'inde görülür (2). Multipl miyelomlu hastalarda orbital tutulum, santral sinir sistemi tutulumları içinde seyrektir (3). İkinci, 3. ve 6. kraniyal sinir tutulumu sık görülür, 6. kraniyal sinir tutulumu bunlar içinde en sık olanıdır (2). Kavernöz sinüs tutulumu ise çok nadirdir ve tedaviye dirençli hastalıkla ve kötü sonuçla birliktedir (5). Multipl myeloma is a systemic disease with neoplastic proliferation of plasma cells. Cavernous sinus involvement is rare in multipl myeloma. The role of imaging with MRI to exclusion of involvement is great because the cavernous sinus can be evaluated very well by magnetic resonance imaging (MRI). Our case, a seventy seven-year-old female patient, applied to our policlinic with visual disturbance in the left eye. In the neurological examination of the patient; left eye was inside in the primer position, bilateral external view limitation was present marked in the left eye and downward view limitation was present in the left eye. Patient's brain MRI showed patchy and nodal signals in the frontoparietal lob borderzone area may be compatible with infarct and causing asymmetric enhancement of the left cavernous sinus and expanding soft tissue lesion was detected. The patient was evaluated as multiple myeloma-associated left cavernous sinus involvement and the patient was directed to oncologic treatment center to re-evaluate her oncologic therapy. Since cavernous sinus involvement is rare in multiple myeloma, we found this patient worthy to present.

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Imaging of extraosseous intracranial and intraspinal multiple myeloma, including central nervous system involvement

Cited by 14 publications

References 15 publications

Cerebrospinal Fluid Cytological Diagnosis in Multiple Myeloma With Leptomeningeal Involvement

Cerebrospinal Fluid Cytological Diagnosis in Multiple Myeloma With Leptomeningeal Involvement

Central nervous system involvement by multiple myeloma: A multi‐institutional retrospective study of 172 patients in daily clinical practice

Cavenous Involvement in a Paint with Multiple Myeloma

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