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Astrocytoma development following complete multiple myeloma remission in a 49-year-old patient: A case report
Xiaoyan Han1, Dian Jin, Gaofeng Zheng
1Multiple Myeloma Center, Bone Marrow Transplantation Center, Department of Hematology, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
Abstract:
Multiple myeloma (MM), one of the B-cell non-Hodgkin lymphomas, is a bone marrow-derived, antibody-producing cancer of the plasma cells. In the advanced stages, the cancer cells frequently cause widespread osteolytic bone damage; however, in rare cases, MM also manifests as an intracranial plasmacytoma. In the present study, we describe a case in which a patient, initially treated for MM and with subsequent complete remission, was admitted to hospital with a lesion in the right cerebellar hemisphere and neurological symptoms of a brain tumor. Our initial diagnosis was an MM relapse with the rare occurring intracranial manifestation. However, pathological tests confirmed the diagnosis of a high-grade astrocytoma. In this case report, we describe the characteristics, as well as the treatment issues, diagnoses and clinical developments of this patient.
Insights
This case report details a patient initially diagnosed with multiple myeloma (MM) who developed a brain tumor. Unexpectedly, pathological tests revealed a high-grade astrocytoma, not an MM relapse.
Area of Science:
- Oncology
- Neurology
- Pathology
Background:
- Multiple myeloma (MM) is a plasma cell cancer often causing bone damage.
- Intracranial plasmacytoma is a rare manifestation of advanced MM.
- Differentiating MM relapse from other brain tumors is clinically challenging.
Purpose of the Study:
- To report a rare case of a patient initially treated for MM.
- To highlight the diagnostic challenge when a brain lesion appears after MM remission.
- To discuss the management of a high-grade astrocytoma mimicking MM relapse.
Main Methods:
- Case report review.
- Clinical data analysis.
- Pathological examination of brain lesion.
Main Results:
- Patient initially treated for MM achieved complete remission.
- Patient presented with neurological symptoms and a cerebellar lesion.
- Pathology confirmed high-grade astrocytoma, not MM recurrence.
Conclusions:
- This case underscores the importance of thorough pathological evaluation for brain lesions in MM survivors.
- High-grade astrocytoma can mimic intracranial MM relapse, necessitating careful diagnosis.
- Accurate diagnosis is crucial for appropriate treatment and patient management.
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