Multiple myeloma revealed by a sphenoid plasmocytoma: case report and literature review

Plasma cell neoplasms can manifest as a solitary or multiple plasmocytomas and may be associated with or progressing to multiple myeloma (MM). Cranial and intracranial plasmocytomas revealing multiple myeloma are very rare and only few cases are reported in the literature. We report the case of a sphenoid plasmocytoma that revealed a multiple myeloma in a 56 year-old woman with 3 months history of temporal headache and diplopia. Magnetic resonance imaging (MRI) and computed tomography (CT) showed a sphenoid mass. An endoscopic sphenoidal biopsy was performed and the histopathological exams showed a plasmocytoma with a positive staining for CD138. Further biological studies confirmed the diagnosis of multiple myeloma with a monoclonal gamma peak of immunoglobulin (Ig) A. The patient started systemic chemotherapy and received decompressive radiation therapy on the sphenoidal sinus. She remained in remission for 8 months and died from renal dysfunction. Although the sphenoid plasmocytoma is a very rare presentation of multiple myeloma it should be considered for effective patient management and prognosis improvement.