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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 49 year old man had had headache and some cranial nerve paralyses for about three years. A tentative diagnosis of meningioma of the skull base or chordoma was made before his death. In the postmortem examination, a large tumor lying on the skull base was found. The sella turcica, a part of the basilar bone were destroyed. The neoplasm had invaded the adjacent cerebrum, cranial nerves and extra-cranial tissues. Histopathologically, the lesion showed a typical poorly-differentiated plasmacytoma. Both clinic and pathologic characteristics of this tumor are discussed and the literature on solitary intracranial plasmacytoma is reviewed.
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PMID:[Solitary intracranial plasmacytoma--a case report and review of the literature]. 376 46

Multiple myeloma frequently affects the C.N.S with a high prevalence of spinal cord compression following vertebral neoplastic infiltration. On the other hand, solitary plasmacytomas, tumors that arise in a wide variety of locations due to the universal distribution of plasma cells, are infrequent within the cranial vault and rarely present as extramedullary lesions, arising from the intracranial soft tissues without affecting neighboring bony structures. Only 33 such cases have been reported in the medical literature. The authors report two additional cases of solitary intracranial, extramedullary plasmacytoma. Case 1.--54 year-old woman with a chief complaint of severe headache and behavioral changes of three months duration. C.N.S. imaging revealed a bifrontal mass lesion, arising from the anterior third of the falx cerebri. Case 2.--45 year old-man who complained of headache and blurred vision of a month duration C.N.S. imaging displayed a third ventricle mass lesion. In both cases the neuropathological diagnosis was extramedullary plasmacytoma. Postoperatively the confirmation of solitary intracranial plasmacytoma was achieved only after a thorough work-up to rule out the presence of neoplasm elsewhere in the body. Radiotherapy was given to both patients and follow-up has failed to reveal neoplastic disease 4 and 3 years, respectively, after the diagnosis.
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PMID:[Extramedullary intracranial solitary plasmocytoma. Report of 2 cases]. 780 51

The patient described, a 51-year-old woman, had diplopia and cephalgia of two weeks' duration. On admission, the radiologic evaluation revealed a mass in the sphenoid sinus, multiple lesions in the calvarium and a solitary lung mass. Biopsy of the lung mass revealed an atypical plasmacytic infiltration. Laboratory findings confirmed the diagnosis of light-chain myeloma presenting with a pulmonary plasmacytoma and cranial nerve involvement.
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PMID:Acute diplopia and a solitary lung mass: a unique presentation of light-chain myeloma. 869 Jun 28

The May 2002 COM. A 38-year-old man presented with new onset seizures and a 69-year-old woman presented with bilateral headaches and episodes of syncope. Both were found to have extra-axial masses that were contrast-enhancing and thought to be meningiomas. Both had complete resection. Microscopic examination revealed an inflammatory lesion composed of plasma cells, scattered lymphocytes and numerous large histocytic cells, which exhibited emperi polesis and were CD1 a negative, but positive for CD68 and S100. The diagnosis of Destombes-Rosai-Dorfman Disease (DRDD) was rendered. Both cases had good long-term outcome. The differential diagnosis of inflammatory masses in the dura (plasmacytoma, lymphomas, plasma cell fibroma, angiofollicular hyperplasia [Castleman's-disease] and Langerhan's cell histiocytosis) are discussed.
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PMID:May 2002: 38-year-old man and 69-year-old woman with dural based masses. 1240 40

This is the case report of a 45-year-old lady presenting with headache and papilledema. Investigations revealed falcotentorial plasmacytoma. Tumor was removed and adjuvant radiotherapy was given. This is curative. There are only 2 previous cases of plasmacytoma involving falx and tentorium simultaneously. En plaque meningioma is the close differential diagnosis.
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PMID:Falcotentorial plasmacytoma: a case report. 1526 19

A sixty six year old female presented with headache and decreased hearing. Clinical examination confirmed the presence of impaired hearing on the left side. Visual fields were full to confrontation and corrected visual acuity was normal. CT scan of brain revealed a pituitary mass. Preoperative anterior pituitary function was normal. Transsphenoidal decompression was performed, and histology was that of a plasmacytoma. Post operative pituitary function was normal. The patient had no symptoms or signs of multiple myeloma and subsequent investigations revealed no evidence of the disease. One year after diagnosis a course of radiotherapy was administered for local tumour recurrence. During seven years of follow-up, no evidence of multiple myeloma has emerged. Only thirteen similar cases have been described. Four of these had evidence of multiple myeloma at presentation and six progressed to it during follow-up. In twelve patients cranial nerve deficits were recorded. In any cases where it was documented, preoperative anterior pituitary function was normal. In a number of cases histology was reported initially as being that of a non-functioning adenoma, the true diagnosis being discovered, either by electron microscopy findings or after the development of multiple myeloma. Plasma cell tumours of the pituitary area are rare and can present with symptoms and signs indistinguishable from non-functioning adenoma. Atypical symptoms such as cranial nerve involvement or unexpected preservation of anterior pituitary function should arouse suspicion.
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PMID:Plasmacytoma: an unusual cause of a pituitary mass lesion. A case report and a review of the literature. 1632 66

Apart from calvarial infiltration, intracranial involvement in multiple myeloma is uncommon. Diffuse leptomeningeal invasion with or without parenchymal involvement is most common. Dural infiltration without involvement of the parenchyma, leptomeninges or skull is rare. The differential diagnosis of a dural plasmacytoma includes meningioma, which has a similar MRI appearance, metastasis, lymphoma and sarcoma of the dura mater. We present a patient with multiple myeloma presenting with an intracerebral mass mimicking a meningioma on MRI. Multiple myeloma had been diagnosed seven years previously. The patient presented with headache and speech disturbance 12 months after autologous peripheral stem cell transplantation for recurrence of multiple myeloma. MRI revealed a left temporal extra-axial mass with a dural tail mimicking meningioma. Histopathological examination of the mass after excision showed multiple myeloma immunopositive for IgG, kappa light chain and CD38. There was no recurrence after postoperative radiotherapy. Plasmacytoma should be considered in the differential diagnosis of a solitary dural mass, particularly in a patient with multiple myeloma.
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PMID:Dural plasmacytoma mimicking meningioma in a patient with multiple myeloma. 1645 88

The authors describe the case of a 72-year-old woman with dural plasmacytoma revealing an immunoglobulin (Ig) G-kappa multiple myeloma (MM). She presented with headaches and left hemiparesis. Magnetic resonance imaging demonstrated a right frontal extraaxial lesion arising from the dura mater, and biological studies revealed hypercalcemia, hyperproteinemia, and a serum gamma globulin peak. A diagnosis of IgG-kappa MM was based on microscopic examination and immunohistochemical analysis of the dural plasmacytoma as well as on signs of systemic myeloma after surgery. The patient died 3 years after the first symptoms of MM despite systemic chemotherapy and no recurrence of the dural plasmacytoma. Myelomatous involvement of the dura mater is a rare occurrence given that only three cases have been reported to date. Nevertheless, this pathological entity should be differentiated from solitary dural plasmacytoma (SDP) because the prognosis is radically different. Progression seems to be correlated with systemic disease in contrast to the long-term survival associated with SDP. Careful systemic evaluation should be made in such a presentation to rule out MM, which would require different management and has a different prognosis.
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PMID:Dural plasmacytoma revealing multiple myeloma. Case report. 1661 66

We report an uncommon case of an intrasellar plasmacytoma presenting as a non-functional invasive pituitary macro-adenoma as the first manifestation of multiple myeloma. A 57 year old woman was referred to our department with a presumed diagnosis of a non-functioning pituitary macro-adenoma. She reported a 3 month history of headaches and a 2 week history of sudden onset of right facial numbness. Preoperative endocrine evaluation was remarkable only for a modestly elevated serum prolactin. A magnetic resonance imaging (MRI) scan revealed 3.6 x 5 x 4 cm enhancing homogeneous intrasellar mass with extension into the sphenoid and cavernous sinuses bilaterally; the optic chiasm was not displaced. She underwent transphenoidal surgery of the sellar lesion. The surgical specimen was heavily infiltrated with abnormal plasma cells, which stained almost exclusively for Kappa light chain immunoglobulins. An extensive investigation was undertaken to look for occult myelomatous disease. A diagnosis of multiple myeloma was made 1 month later based on a combination of clinical, pathological and radiologic features. She underwent radiation therapy directed towards the residual sellar tumor, followed by chemotherapy and autologous stem cell transplantation. Review of the world literature revealed only 22 previous reports of patients in whom a solitary plasmacytoma or multiple myeloma first presented as a sellar mass; in all cases mimicking clinically and radiologically a non-functioning invasive pituitary adenoma however with additional cranial nerve involvement. Intrasellar plasma cell tumors are rare tumors which may mimic non-functioning invasive pituitary tumors. The diagnosis should be suspected in patients with well preserved anterior pituitary function and cranial nerve neuropathies in the presence of significant sellar destruction.
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PMID:Intrasellar plasmacytoma presenting as a non-functional invasive pituitary macro-adenoma: case report & literature review. 1670 11

A 60-year-old male presented with headache and diplopia for 2 months. Computed tomography of the head showed a heterogeneously enhancing expansile lytic lesion in clival region. The patient underwent surgery and histopathological examination revealed it to be plasmacytoma of the clivus. The multiple myeloma work-up was negative. Solitary plasmacytoma localized to the skull base is extremely rare. Prior to this, only three case reports of plasmacytoma of the clivus have been described in the English literature.
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PMID:Plasmacytoma of the clivus: a case report. 1718 58


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