Dural Plasmacytoma with Meningeal Myelomatosis in a Patient with Multiple Myeloma
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Published on: July 15, 2015
Nieves Gascón1, Héctor Pérez-Montero1, Sandra Guardado1
1Radiation Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
Abstract:
Here, we describe the case of a 66-year-old male diagnosed with multiple myeloma who presented with generalized tonic-clonic seizures. Magnetic resonance imaging demonstrated a right solid extra-axial parieto-occipital lesion with typical characteristics of meningeal myelomatosis. Biopsy was performed, which diagnosed a dural plasmacytoma. Because of this, we started concomitant therapy with radiotherapy and lenalidomide, but the patient has a poor response to treatment and died few weeks after its initiation. Myelomatous involvement of the dura mater is a rare occurrence, given that only few cases were reported in the English literature. This presentation confers an ominous prognosis and must be a suspect diagnosis in patients diagnosed with multiple myeloma presenting neurological symptoms.
Insights
A rare case of dural plasmacytoma, a form of multiple myeloma affecting the dura mater, presented with seizures. Despite treatment, the patient had a poor outcome, highlighting the aggressive nature of this rare condition.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- Multiple myeloma is a hematologic malignancy.
- Neurological complications can occur in multiple myeloma patients.
- Dural involvement by myeloma is exceptionally rare.
Observation:
- A 66-year-old male with multiple myeloma presented with generalized tonic-clonic seizures.
- MRI revealed a right parieto-occipital extra-axial lesion.
- Biopsy confirmed a dural plasmacytoma.
Findings:
- The patient exhibited poor response to combined radiotherapy and lenalidomide therapy.
- The patient died shortly after treatment initiation.
- Myelomatous involvement of the dura mater is associated with an ominous prognosis.
Implications:
- Dural plasmacytoma must be suspected in multiple myeloma patients with neurological symptoms.
- Early diagnosis and novel therapeutic strategies are crucial.
- Further research is needed to understand and manage this rare complication.
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