Plasmacytoma of the Skull-base: A Rare Tumor

Abstract

Plasmacytoma of the skull-base is a rare entity. Differential diagnosis includes chordoma, osteosarcoma, carcinoma nasopharynx, meningioma, metastatic carcinoma, lymphoma, and multiple myeloma. Accurate and precise diagnosis is extremely important for plasmacytoma of the skull-base as its treatment and prognosis is different from other skull-base lesions. A 41-year-old man presented with concerns of headache, diplopia, and left eye strabismus. A magnetic resonance image (MRI) of his brain showed a large expansile mass measuring 51 mm involving the clivus and central skull-base. Trans-sphenoidal tumor decompression was done. A biopsy confirmed the plasmacytoma. A positron emission tomography-computed tomography (PET-CT) scan showed a single 2-(18F) fluoro-D-glucose (FDG) avid lesion at the skull-base. The results of all other relevant investigations such as hemoglobin, renal function test, serum calcium, serum protein immunoelectrophoresis, serum quantitative immunoglobulin, bone marrow biopsy, serum lactate dehydrogenase, and beta-2 microglobulin levels were within normal limits. He was treated with radical radiotherapy. He developed complete clinical response after radiotherapy.

Acúfeno como síntoma inicial de plasmocitoma de hueso temporal

“…RMN T1 con contraste con lesión hiperintensa que ocupa fosa media y ángulo pontocerebeloso, hasta seno esfenoidal. que se presentaron en un mayor porcentaje son: CD138 en 7 de los 13 reportes, CD38 y CD56 en 3/13, CD79 en 2/13 y CD128 en 1/13, siendo el marcador tumoral más común el CD138 encontrado en un 70% en la inmunohistoquímica del presente caso [2][3][4][5][6][7][8][9] . Los 45 pacientes publicados en los 14 reportes de casos y series de casos (Tabla 1) fueron tratados con radioterapia, excepto un paciente que se trató con cyberknife, sin embargo, varios pacientes con plasmocitoma de base de cráneo progresaron a mieloma múltiple, tratados con quimioterapia en la mayoría de las ocasiones.…”

“…El papel de la cirugía permite confirmar el diagnóstico, y puede ser útil en caso de descompresión. De los 14 reportes de casos y series de casos publicados [1][2][3][4][5][6][8][9][10][11][12][13][14][15] (Tabla 1), varios fueron sometidos a cirugía de descompresión, cirugía de descompresión endoscópica y un paciente a cirugía con radiocirugía estereotáxica con cyberknife.…”

“…Debido a su baja incidencia, es difícil la realización de revisiones sistemáticas que permitan llegar a un consenso en cuanto al tratamiento óptimo del plasmocitoma de base de cráneo. Sólo existen escasos casos y series de casos publicados, los cuales se resumen en la Tabla 1 [1][2][3][4][5][6][8][9][10][11][12][13][14][15] .…”

Complete Resolution of Skull Base Solitary Plasmacytoma Using Proton-Beam Radiotherapy: A Case Report

“…Although rare, plasmacytomas of the skull base have previously been reported. The radiographic differential diagnosis for such tumors at the skull base is wide, but the more common pathologies include meningioma, chordoma, osteosarcoma, metastasis, and others [ 1 ]. Classic symptoms of skull base plasmacytomas include headache, double vision [ 2 ], and vertigo [ 3 ].…”

“…Since plasmacytomas are highly chemo/radio-sensitive than several other skull base tumors, prompt and accurate diagnosis is imperative [ 1 , 3 , 10 ]. Here we present a unique-and to our knowledge, previously unreported-case of a skull base plasmacytoma treated solely with proton radiation therapy.…”