Solitary intracranial plasmacytoma

A case of solitary plasmacytoma involving the left cerebral convexity, dura mater, falx, and sagittal sinus is reported. After undergoing subtotal excision, followed by radiation, the patient was still doing well seven years after diagnosis. The importance of electrophoretic studies of the cerebrospinal fluid protein and the serum protein is discussed. The literature on solitary intracranial plasmacytoma is reviewed.     

Solitary plasmacytoma of the rib

Solitary plasmacytoma of the bone, and especially of a single rib, is a rare disease. Here we report a 73-year old male patient complaining of continuous chest wall pain around the right 5th rib shaft who underwent a wide excision of the rib tumor with surrounding connective tissue. He was diagnosed with solitary plasmacytoma and will undergo radiation therapy. We report this case with a review of the literature.     

Solitary plasmacytoma simulating pituitary adenoma

A case of solitary plasmocytoma of the sphenoid is reported, masquerading as pituitary adenoma. At the time of surgery, the patient had no findings of multiple myeloma. The tumor was removed by trans-sphenoidal route and radiotherapy delivered. The post-operative course was uneventful, and two years later, there is no sign of recurrency or extension of multiple myeloma.     

Solitary thoracic intradural extramedullary plasmacytoma

Summary The bodies of the vertebrae are common locations for plasma cell diseases such as multiple myeloma and solitary plasmacytoma. Secondary invasion of the epidural space is infrequent but can cause neurological symptoms. Spinal cord compression due to pure intradural plasma cell infiltration is very rare. The authors report a 25-year-old woman who developed a progressive difficulty in walking due to a solitary spinal dural plasmacytoma. This is the first reported example in the English language literature of a purely intradural spinal plasmacytoma in a patient without other myelomatous lesions. An entirely intradural solitary plasmacytoma has a relatively better prognosis.     

胸骨孤立性浆细胞瘤1例

患者女,67岁,因“胸骨上段包块进行性增大伴疼痛6月余,疼痛加重1月余”入院。查体:胸骨上段扪及包块,质韧,活动度差,有压痛,皮肤无红肿。实验室检查:血常规、肾功能、电解质未见异常,血清免疫球蛋白κ轻链14.70 g/L、κ/λ3.551。胸部CT:胸骨柄及胸骨体上段3.8 cm×5.7 cm×7.1 cm膨胀性溶骨性骨质破坏伴软组织密度充填,边界清楚,平扫CT值约65 HU,增强后均匀强化,CT值约113 HU,骨皮质中断、硬化,呈花边样改变(图1A、1B);考虑肿瘤性病变。行胸骨穿刺活检,病理报告:弥散性分布浆细胞样小细胞(图1C);免疫组织化学:CD79a(+),CD38(+),CD138(+)(图1D),κ(+),λ(-),MUM-1(+),CD56(+),Ki-67(约5%+);提示胸骨浆细胞瘤。99 m Tc全身骨显像显示胸骨柄及胸骨体上段显像剂浓聚,考虑肿瘤;双膝内侧显像剂浓聚,考虑退行性改变(图1E)。双膝MRI未见骨质破坏。穿刺髂骨抽取骨髓液后行多发性骨髓瘤流式细胞分析,结果示正常多克隆浆细胞。综合诊断:胸骨孤立性浆细胞瘤(solitary plasmacytoma,SP)。     

Solitary plasmacytoma of the sphenoid. A case report

A rare case of sphenoidal plasmacytoma in a 79 year-old male patient is reported. The diagnosis was preoperatively considered because of associated dysproteinemia and it was histopathologically confirmed on a transphenoidal biopsy specimen. Initial evaluation disclosed no systemic dissemination of the disease and a solitary plasmacytoma was diagnosed. Radiotherapy was delivered with subsequent clinical improvement and significant tumor reduction was illustrated on follow-up imaging studies. Twenty-two months after diagnosis, the patient remains asymptomatic without evidence of transformation to multiple myeloma. Only 7 comparable cases have been reported in the literature. The diagnostic, pathological and nosographic features of sphenoid plasmacytomas are discussed.     

Solitary plasmacytoma of the skull. A case report

A case of solitary plasmacytoma of the skull is presented. The tumor was radically removed. There was no systemic involvement and the patient was not submitted to radiotherapy. Lytic lesions of the skull are discussed.     

The hyoid bone syndrome

Various causes of head and neck pain have been described in the literature. In 1954 Brown described a so-called hyoid bone syndrome, ie, tenderness at the site of the greater cornu of the hyoid bone. His paper, however, did not offer any definitive treatment. In 1968 Steinmann reported the hyoid bone syndrome as a form of "insertion tendinois," for which he recommended the use of procaine hydrochloride injection with corticosteroid at the tip of the greater hyoid cornu for relief of pain. The relief, however, was temporary. The purpose of this paper is to present the symptom complex of the hyoid bone syndrome, its diagnosis by exclusion, and excision of the greater cornu in 18 patients for permanent relief of head and neck pain.     

Solitary plasmacytoma of the upper cervical spine: therapeutic considerations

Solitary plasmacytomas are localized plasma cell malignancies involving bone marrow (solitary bone plasmacytoma, SBP) or extramedullary tissues (solitary extramedullary plasmacytoma, SEP). The upper cervical spine involvement by SBP is a rare and more challenging condition. The authors describe a patient with solitary plasmacytoma involving all the elements of C2 vertebra. Severe neck pain was the only manifestation of disease. The patient underwent an occipito-cervical stabilization with a partial decompression through a single posterior approach. The authors stress the importance of early diagnosis followed by appropriate multidisciplinary treatment strategies, including surgery and discuss the management dilemmas concerning the timing and management consequence, in scope to prevent a major neurological damage and allow the patient to be ambulatory.     

Solitary intramedullary plasmacytoma of the skull base mimicking aggressive meningioma

The authors present an unusual case of solitary intramedullary plasmacytoma. Awareness of this entity can facilitate appropriate surgical planning, which may include a limited biopsy prior to considering more extensive skull base surgery.     

Carotid artery entrapment by the hyoid bone

We report a patient with a transient ischemic attack presumably caused by an entrapment of the internal carotid artery by the hyoid bone and without a significant carotid artery stenosis. The patient was operated on, with a release of the right internal and external carotid artery and resection of the right greater cornu of the hyoid bone. One year after treatment, the patient has not experienced any further neurologic symptoms, and a color duplex scan showed no stenosis of the right carotid artery. The hyoid bone is a potential cause of damage to the carotid vessels, depending on the individual's anatomy. Provocative maneuvers can be performed in patients with cerebrovascular symptoms who are not demonstrated to have significant anatomic stenosis with carotid imaging.     

Solitary plasmacytoma in the thoracic spine. Two case reports

Plasmacytoma of the spine is rather common, but solitary occurence is not. We report two cases of solitary plasmacytomas in the thoracic spine. A 72 year old male and a 77 year old male presented with progressive paraparesis. In both cases, magnetic resonance images revealed tumors in the thoracic spine which predominantly occupied the posterior elements of the spine with compression of the spinal cord. Abnormal proteinuria and proteinemia were not detected. The tumors were removed and patients' symptoms improved, the tumors were diagnosed by histopathology to be plasmacytomas. Further neuroradiological studies suggested them to be single lesions, so that the final diagnosis was solitary plasmacytomas. Solitary plasmacytoma should be considered for diagnosis of single spinal lesion even without abnormal proteinemia or proteinuria.