Intracranial Calcification Masquerading as Hemorrhage in a Patient with Multiple Myeloma Presenting with Facial...

Area of Science:

• Neurology
• Oncology
• Radiology

Background:

• Multiple myeloma, a plasma cell neoplasm, commonly affects bones, kidneys, and the hematopoietic system, with nervous system involvement being less frequent.
• Peripheral nervous system complications like neuropathy are common, while central nervous system disorders include compressive myelopathy, cerebrovascular issues, and intracranial plasmacytomas.
• Intracranial calcifications are rare in multiple myeloma, unlike metastatic calcifications in other organs.

Observation:

• A rare case of intracranial calcification mimicking acute intracerebral hemorrhage is presented.
• The patient, diagnosed with multiple myeloma, presented with acute facial weakness.
• Imaging revealed intracranial calcifications that initially appeared as an acute intracerebral hemorrhage.

Findings:

• The unusual presentation underscores the importance of considering rare differential diagnoses in patients with multiple myeloma.
• Diagnostic imaging can be challenging, requiring careful interpretation to distinguish calcification from hemorrhage.
• This case expands the spectrum of neurological manifestations associated with multiple myeloma.

Implications:

• Recognizing intracranial calcification as a rare manifestation of multiple myeloma is crucial for accurate diagnosis and management.
• This finding may prompt further investigation into the mechanisms underlying intracranial calcification in myeloma.
• Clinicians should maintain a high index of suspicion for atypical neurological presentations in multiple myeloma patients.