Abstract
Plasma cell neoplasms are clonal proliferation of plasma cells that produce a single class of immunoglobulin. Among the plasma cell neoplasms, both solitary plasmacytoma of bone and extra-osseous plasmacytoma can progress to multiple myeloma. Here, we described a rare case of multiple myeloma with initial presentation as plasmacytoma with both intracranial and extracranial component, sphenoid sinus involvement and left sided vision loss. Serum protein electrophoresis revealed presence of M spike. Histopathological and immunohistochemical analysis detected plasmacytoma. Extramedullary plasmacytoma is a rare presentation of multiple myeloma. Intracranial involvement and involvement of sphenoid sinus of plasmacytoma with pressure effect mimicking other intracranial neoplasm is extremely rare. Clinicians should consider this entity in any solitary intracranial neoplasm with rapid progression of clinical course.
Keywords: Multiple myeloma, Intracranial plasmacytoma, Sphenoid sinus, Unusual presentation.
References
- H. Swerdlow, E. Campo, S. A. Pileri et al., “The 2016 revision of the World Health Organization classification of lymphoid neoplasms,” Blood. 2016;127 (20):2375–2390
- Gupta D, Goyal J. A rare case of extramedullary plasmacytoma arising from posterior mediastinum. Indian J Cancer 2015;52:428-9
- Knowling MA, Harwood AR, Bergsagel DE. Comparison of extramedullary plasmacytomas with solitary and multiple plasma cell tumors of bone. J ClinOncol. 1983;1:255–62
- Kawano Y, Fujiwara S, et al. Multiple myeloma cells expressing low levels of CD138 have an immature phenotype and reduced sensitivity to lenalidomide. International Journal of Oncology. 2012; 41: 876-884
- Dhodapkar MV, Abe E, Theus A, et al: Syndecan-1 is a multi¬functional regulator of myeloma pathobiology: control of tumor cell survival, growth, and bone cell differentiation. Blood. 1998;91: 2679-2688
- Sahara n, Takeshita A et al. Clinicopathological and prognostic characteristics of CD56-negative multiple myeloma. Br J Haematol. 2002 Jun;117(4):882-5
- Kyle RA, Rajkumar SV. Criteria for diagnosis, staging, risk identification and response assessment of multiple myeloma.Leukemia.2009;23(1):3-9
- Ngo NT, Brodie C, Giles C et al. The significance of tumour cell immunophenotyped in myeloma and its impact on clinical outcome. J ClinPathol. 2009; 62(11): 1009-1015
- Bachmeyer C1, Levy V, Carteret M, et al. Sphenoid sinus localization of multiple myeloma revealing evolution from benign gammopathy. Head Neck. 1997; 19:347–50.
- Rajkumar SV, Gahrton G, Bergsagel PL. Approach to the treatment of multiple myeloma: a clash of philosophies. Blood.2011; 118:3205–11.
Corresponding Author
Dr Malay Sarkar
Flat 2 A & B, Kamala Apartment, 12, R. N. Avenue, PO – Panshila, Kolkata – 700112
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DOI: https://dx.doi.org/10.18535/jmscr/v5i10.111
