e5 - Available online at http:/www.biij.org/2009/2/e5 doi:

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biij Biomedical Imaging and Intervention Journal CASE REPORT Dural plasmacytoma mimicking meningioma in a young patient with multiple myeloma NN Rahmah *,1,2 , MD, HK Brotoarianto 2 , MD, E Andar 2 , MD, G Kusnarto 2 , MD, Z Muttaqin 2 , MD, K Hongo 1 , MD 1 Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan 2 Department of Neurosurgery, Diponegoro University, Dr. Kariadi Hospital, Semarang, Indonesia Received 12 November 2008; received in revised form 21 January 2009, accepted 21 January 2009 Part of the paper was presented at AACNS meeting in Nagoya, November 2007 ABSTRACT Intracranial involvement in multiple myeloma (MM) is rarely found, especially with dural involvement. There are only a few cases found concerning MM with intracranial involvement. MM usually involves an older group of patients. Cases involving young patients are very rare. The differential diagnosis of a dural plasmacytoma includes meningioma, metastasis, lymphoma and sarcoma of the dura mater. We present a young patient, 33 years old, with MM presenting an intracerebral mass mimicking meningioma on MRI. MM was diagnosed the previous year. The patient presented with headache, balance disturbance and back pain. MRI revealed an occipital extra-axial mass with a dural tail. Histopathological examination after excision showed MM. Published literatures on intracranial involvement of MM are also discussed. Plasmacytoma should be considered in the differential diagnosis of a solitary dural mass, particularly in a patient with MM. © 2009 Biomedical Imaging and Intervention Journal. All rights reserved. Keywords: multiple myeloma, posterior fossa, intracranial plasmacytoma INTRODUCTION Multiple myeloma (MM) is a malignant tumor that may involve the vertebrae and cranium. In the skull, they are typically multiple lytic lesions, exhibiting a ‘moth- eaten’ appearance on radiograph [1]. The term plasmacytoma refers to a single lytic lesion of malignant plasma cells infiltration. From a classical point of view; intracranial plasmacytomas and MM may involve the cranial vault and/or the skull base only, the brain parenchyma, arising in the cranial vault and/or the skull base and the orbit [2]. However, intracranial involvement in plasmacytomas and MM is rare [2]. In this study, an intracranial mass of dural origin in a patient with one year history of MM is reported. Review of the literatures is also presented. * Corresponding author. Present address: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan. Tel: +818032027926; Fax: +81263370480; E-mail: [email protected] (Nunung Nur Rahmah). Available online at http://www.biij.org/2009/2/e5 doi: 10.2349/biij.5.2.e5
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CASE REPORT A 33-year-old male was referred to the neurosurgical department by an internist with chronic headache. MRI study (0.5 T) performed revealed a posterior fossa mass. The mass was located behind the cerebellum, 31.3 x 31.2 x 23.0 mm in size and enhances
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This note was uploaded on 12/11/2009 for the course UNT 123456 taught by Professor 123456 during the Spring '09 term at University of North Texas Health Science Center.

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e5 - Available online at http:/www.biij.org/2009/2/e5 doi:

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