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A Steroid-Sensitive Solitary Intracranial Plasmacytoma

A Steroid-Sensitive Solitary Intracranial Plasmacytoma Abstract A patient with a solitary intracranial plasmacytoma had involvement of the meninges, but not bone. To our knowledge, it represents the tenth reported case of this type. Two of the previously reported cases involved primarily brain substance, while the rest, including this case, involved primarily the meninges. This lesion closely simulated optic neuritis in this initial clinical presentation and then became a steroid-responsive lesion. A discrete band in the gamma region of the agar gel electrophoresis of the cerebrospinal fluid (CSF) was found in the face of a normal, standard CSF and serum electrophoresis, which disappeared after surgery and therapy with radiation. To our knowledge, this has not been reported previously, although an abnormal standard spinal fluid electrophoresis with an increase in the γ-globulin was reported in several of the previous cases. The changing pathological findings in our case are interesting in light of the possible origin of the plasmacytoma. References 1. Clarke E: Cranial and intracranial myelomas . Brain 77:61-81, 1954.Crossref 2. Carson CP, Ackerman LV, Maltby JD: Plasma cell myeloma: A clinical, pathological, and roentgenologic review of 90 cases . Am J Clin Pathol 25:849-887, 1955. 3. Tilden IL: Solitary myeloma of the skull: Preliminary report . Proc Staff Meet Clin 7:79-83, 1941. 4. Medoc J, Rodriguez B, Rodriguez JJ: Mieloma meningeo . An Fac Med Montev 46:82-91, 1961. 5. Kaufman J: Isolated myeloma in a 14-year-old boy . Am J Surg 69:129-132, 1945.Crossref 6. Cappel DF, Mathers RP: Plasmacytoma of the petrous temporal bone and base of skull . J Laryngol Otol 50:340-349, 1935.Crossref 7. Mathias E: Zur Myelomfrage . Bruns Beitr Klin Chir 161:79-87, 1935. 8. Kamin DF, Hepler RS: Solitary intracranial plasmacytoma mistaken for retrobulbar neuritis . Am J Ophthalmol 73:584-586, 1972. 9. Coleman DJ, Carroll FD: Evaluation of optic neuropathy with B-scan ultrasonography . Am J Ophthalmol 74:915-920, 1972. 10. French JD: Plasmacytoma of the hypothalamus: Clinicopathological report of a case . J Neuropathol Exp Neurol 6:265-270, 1947.Crossref 11. Weiner LP, Anderson PN: Cerebral plasmacytoma with myeloma protein in the cerebrospinal fluid . Neurology 16:615-618, 1966.Crossref 12. Moossy J, Wilson CB: Solitary intracranial plasmacytoma . Arch Neurol 16:212-216, 1967.Crossref 13. Chang SC, Jing BS: Solitary plasmacytoma in the cranial cavity . J Neurosurg 33:471-474, 1970.Crossref 14. Someren A, Osgood CP, Brylski J: Solitary posterior fossa plasmacytoma: Case report . J Neurosurg 35:223-228, 1971.Crossref 15. Case records of the Massachusetts General Hospital, weekly clinicopathological exercises case 3-1973 . N Engl J Med 1973, pp 150-156. 16. Innes J, Newall J: Myelomatosis . Lancet 1:239-245, 1961.Crossref 17. Christopherson WM, Miller AJ: A re-evaluation of solitary plasma-cell myeloma of bone . Cancer 3:240-252, 1950.Crossref 18. Link H, Muller R: Immunoglobulins in multiple sclerosis and infections of the nervous system . Arch Neurol 25:326-344, 1971.Crossref 19. Rappaport H: Tumors of the hematopoietic system , in Atlas of Tumor Pathology , sect 3 fasc 8. Armed Forces Institute of Pathology, 1966, pp 207-213. 20. Pascoe HR, Dorfman RF: Extramedullary plasmacytoma of the submaxillary gland . Am J Clin Pathol 51:501-507, 1969. 21. Okano H, Azar HA, Osserman EF: Plasmacytic reticulum cell sarcoma: Case report with electron microscopic studies . Am J Clin Pathol 46:546-555, 1966. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

A Steroid-Sensitive Solitary Intracranial Plasmacytoma

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Publisher
American Medical Association
Copyright
Copyright © 1974 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1974.01010010405006
Publisher site
See Article on Publisher Site

Abstract

Abstract A patient with a solitary intracranial plasmacytoma had involvement of the meninges, but not bone. To our knowledge, it represents the tenth reported case of this type. Two of the previously reported cases involved primarily brain substance, while the rest, including this case, involved primarily the meninges. This lesion closely simulated optic neuritis in this initial clinical presentation and then became a steroid-responsive lesion. A discrete band in the gamma region of the agar gel electrophoresis of the cerebrospinal fluid (CSF) was found in the face of a normal, standard CSF and serum electrophoresis, which disappeared after surgery and therapy with radiation. To our knowledge, this has not been reported previously, although an abnormal standard spinal fluid electrophoresis with an increase in the γ-globulin was reported in several of the previous cases. The changing pathological findings in our case are interesting in light of the possible origin of the plasmacytoma. References 1. Clarke E: Cranial and intracranial myelomas . Brain 77:61-81, 1954.Crossref 2. Carson CP, Ackerman LV, Maltby JD: Plasma cell myeloma: A clinical, pathological, and roentgenologic review of 90 cases . Am J Clin Pathol 25:849-887, 1955. 3. Tilden IL: Solitary myeloma of the skull: Preliminary report . Proc Staff Meet Clin 7:79-83, 1941. 4. Medoc J, Rodriguez B, Rodriguez JJ: Mieloma meningeo . An Fac Med Montev 46:82-91, 1961. 5. Kaufman J: Isolated myeloma in a 14-year-old boy . Am J Surg 69:129-132, 1945.Crossref 6. Cappel DF, Mathers RP: Plasmacytoma of the petrous temporal bone and base of skull . J Laryngol Otol 50:340-349, 1935.Crossref 7. Mathias E: Zur Myelomfrage . Bruns Beitr Klin Chir 161:79-87, 1935. 8. Kamin DF, Hepler RS: Solitary intracranial plasmacytoma mistaken for retrobulbar neuritis . Am J Ophthalmol 73:584-586, 1972. 9. Coleman DJ, Carroll FD: Evaluation of optic neuropathy with B-scan ultrasonography . Am J Ophthalmol 74:915-920, 1972. 10. French JD: Plasmacytoma of the hypothalamus: Clinicopathological report of a case . J Neuropathol Exp Neurol 6:265-270, 1947.Crossref 11. Weiner LP, Anderson PN: Cerebral plasmacytoma with myeloma protein in the cerebrospinal fluid . Neurology 16:615-618, 1966.Crossref 12. Moossy J, Wilson CB: Solitary intracranial plasmacytoma . Arch Neurol 16:212-216, 1967.Crossref 13. Chang SC, Jing BS: Solitary plasmacytoma in the cranial cavity . J Neurosurg 33:471-474, 1970.Crossref 14. Someren A, Osgood CP, Brylski J: Solitary posterior fossa plasmacytoma: Case report . J Neurosurg 35:223-228, 1971.Crossref 15. Case records of the Massachusetts General Hospital, weekly clinicopathological exercises case 3-1973 . N Engl J Med 1973, pp 150-156. 16. Innes J, Newall J: Myelomatosis . Lancet 1:239-245, 1961.Crossref 17. Christopherson WM, Miller AJ: A re-evaluation of solitary plasma-cell myeloma of bone . Cancer 3:240-252, 1950.Crossref 18. Link H, Muller R: Immunoglobulins in multiple sclerosis and infections of the nervous system . Arch Neurol 25:326-344, 1971.Crossref 19. Rappaport H: Tumors of the hematopoietic system , in Atlas of Tumor Pathology , sect 3 fasc 8. Armed Forces Institute of Pathology, 1966, pp 207-213. 20. Pascoe HR, Dorfman RF: Extramedullary plasmacytoma of the submaxillary gland . Am J Clin Pathol 51:501-507, 1969. 21. Okano H, Azar HA, Osserman EF: Plasmacytic reticulum cell sarcoma: Case report with electron microscopic studies . Am J Clin Pathol 46:546-555, 1966.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Nov 1, 1974

References