Huge Size Intracranial Plasmacytoma Treated with Surgery and Fractionated Stereotactic Radiotherapy

  • Choi, Woo-Jin (Departments of Neurosurgery, College of Medicine, In-je University, Ilsan Paik Hospital) ;
  • Yee, Gi-Taek (Departments of Neurosurgery, College of Medicine, In-je University, Ilsan Paik Hospital) ;
  • Choi, Chan-Young (Departments of Neurosurgery, College of Medicine, In-je University, Ilsan Paik Hospital) ;
  • Whang, Choong-Jin (Departments of Neurosurgery, College of Medicine, In-je University, Ilsan Paik Hospital)
  • Published : 2006.08.30

Abstract

Surgery and radiotherapy are mainly used for plasma cell neoplasm which constitutes about $1{\sim}2%$ of human malignancy. The authors carried out Fractionated Stereotactic Radiotherapy[FSRT] on the residual tumor after the subtotal removal of Intracranial plasmacytoma. A huge mass lesion was observed on MRI [magnetic resonance image] in the left anterior and middle cranial fossa of a 63-year-old man with left exophthalmus which lasted for a month, and was suspected as a meningioma with strong contrast enhancement. Extramedullary plasmacytoma was diagnosed on histopathological examination. After the surgery, FSRT was also carried out on the residual tumor which invaded the skull base. One-year follow up after FSRT showed contrast enhancement only in the left sphenoid bone on MRI, which indicated significant decrease in the size of the tumor without any abnormal neurologic deficits. We treated intracranial plasmacytoma which invaded left anterior and middle cranial fossa and surrounded cavernous sinus without cranial nerve deficit through subtotal tumor removal and FSRT.

Keywords

References

  1. Bindal AK, Bindal RK, Van LH, Sawaya R : Management of intracranial plasmacytoma. J Neurosurg 83 : 218-221, 1995 https://doi.org/10.3171/jns.1995.83.2.0218
  2. Han JH, Park HK, Min CK, Cho JK, Park SC, Lee KJ, et al : Solitary Plasmacytoma of the skull. J Korean Neurosurg Soc 29 : 701-705, 2000
  3. Hu K, Yahalom J : Radiotherapy in the management of plasma cell tumors. Oncology 14 : 101-111, 2000
  4. Kim HS, Lee KS, Kim TS : Solitary Plasmacytoma of the skull base. J Korean Neurosurg Soc 24 : 589-593, 1995
  5. Krumholz A, Weiss HD, Jiji VH, Bakal D, Krish MB : Solitary intracranial plasmacytoma : two patients with extended follow-up. Ann Neurol 11 : 529-532, 1982 https://doi.org/10.1002/ana.410110514
  6. Lewanski CR, Bates T, Bowen J, Ashford RF : Solitary bone plasmacytoma : management of isolated local relapse following radiotherapy. Clin Oncol 11 : 348-351, 1999 https://doi.org/10.1053/clon.1999.9078
  7. Liebross RH, Ha CS, Cox JD, Weber D, Delasalle K, Alexanian R : Clinical course of solitary extramedullary plasmacytoma. Radiother Oncol 52 : 245-249, 1999 https://doi.org/10.1016/S0167-8140(99)00114-0
  8. Lim YW, Shin KM, Song JH, Kim MH : Meningeal and cerebral invlovement of a plasmacytoma in an IgG multiple myeloma patient. J Korean Neurosurg Soc 32 : 162-164, 2002
  9. Mantyla R, Kinnunen J, Bohling T : Intracranial plasmacytoma : a case report. Neuroradiology 38 : 646-649, 1996 https://doi.org/10.1007/s002340050325
  10. Strojan P, Soba E, Lamovec J, Munda A : Extramedullary plasmacytoma : clinical and histopathologic study. Int J Radiat Oncol Biol Phys 53 : 692-701, 2002 https://doi.org/10.1016/S0360-3016(02)02780-3
  11. Tsang RW, Gospodarowicz MK, Pintilie M, Bezjak A, Wells W, Hodgson DC, et al : Solitary plasmacytoma treated with radiotherapy : impact of tumor size on outcome. Int J Radiat Oncol Biol Phys 50 : 113-120, 2001 https://doi.org/10.1016/S0360-3016(00)01572-8