Primary plasmacytoma of the cranial vault: a case report

Abstract

We report one case of a 78-year-old woman who referred to our hospital because of a progressive right hemiparesis. On clinical examination a painless large soft mass in the left parietal region was observed. CT and MRI revealed an extra-axial mass in the in the left fronto-temporo-parietal region. The lesion was totally excised despite the bleeding tendency. Histology disclosed the presence of a plasmacytoma. Postoperative, the patient developed an epidural hematoma that required immediate evacuation. On further investigation active tuberculosis was detected. On follow up examination 1 year later no tumor recurrence or evidence of multiple myeloma was detected.

A Large Mass Mimicking Calcified Hematoma of the Skull Showing Involvement of Myeloma Cells and a Good Response to Irradiation

“…The tumors are rather hemorrhagic, and postoperative hemorrhagic complications have been reported. 5 Here, as MRI showed flow void signs and well-enhanced linear features within the tumor, suggestive of high-flow blood vessels, extensive surgical removal was considered to be risky. Biopsy confirmed the diagnosis of cranial involvement.…”

“…The skull is one of the most frequent sites for myeloma cell invasion, and punched-out or lytic lesions are common. However, presentation in the form of a large mass is quite unusual, 1 2 5 and only a limited number of such cases have been reported. 6 7 Although the present patient was referred to us with a tentative diagnosis of calcified hematoma, we suspected skull involvement of myeloma because multiple lytic skull lesions were present as well as the large mass.…”

Skull vault plasmacytoma mimicking parasagittal meningioma: “Mini-brain appearance”

“…The prognosis of solitary plasmacytomas and extramedullary plasmacytomas is better as compared to that of multiple myeloma. [ 7 8 ] These patients must be followed up closely to detect progression to multiple myeloma.…”

POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, multiple myeloma and skin changes) with cranial vault plasmocytoma and the role of surgery in its management: a case report

“…Therefore, a total of 41 cases of cranial vault plasmocytoma have been reported most of which were located in the parietal and occipital bones; frontal localization seems to be less frequent. Not all cases had erosion of the underlying bone and most of them showed an improvement of the symptoms after surgical removal, which is generally followed by radiotherapy [ 8 , 9 ].…”