Giant plasmocytoma of frontal cranium as a rare first manifestation of multiple myeloma – case report

Abstract

Abstract Introduction: Plasmocytomas are lesions that are rarely encountered in neurosurgical practice. Whereas multiple myeloma (MM) occures primarly in bone marrow, solitary plasmocytomas present exclusively extramedullary or as a solitary bone plasmocytoma. Although typical first manifestation of MM are osseus lesions, there are only few case reports in medical world literature of first MM presentation as a single cranial tumor of the skull vault. Clinical presentation: A 63-year-old male with a 4-month history of painless scalp swelling was sent to our department after an unsuccessful attempt to remove the tumor. The patient was neurologically intact and his general condition was good. Bifrontal craniectomy was performed in order to obtain a total resection of the lesion. The tumor was histologically diagnosed as plasmocytoma. Postoperative bone marrow biopsy demonstrated myeloma cells. The subsequent combined therapy had been successful and the patient is in a good condition almost 3 years after the procedure. Conclusion: As an uncommon type of solid tumors, plasmocytomas may mimic other neoplasms, which can lead to delay of diagnosis and proper treatment. Satisfying effects of treatment might occur only with proper diagnostic schema, which should be employed despite the rarity of plasmocytomas in daily clinical practice.