CT and MRI features of multiple myeloma associated with plasmacytoma located in the spheno-clival region: three cases and literature review
Department of Medical Imaging, Jinling Hospital Affiliated to Nanjing University(Nanjing General Hospital of Nanjing Military Region), Nanjing 210002, China
Abstract:Objective: To explore the clinical and imaging characteristics of plasmacytoma located in the spheno-clival region with multiple myeloma. Methods: The clinical materials and imaging information of three cases clinically confirmed spheno-clival plasmacytoma with multiple myeloma were reported. All of them performed CT and MRI scanning in our hospital. Results: In all of the three cases, homogeneous iso-density mass grew in the spheno-clival region with lytic bone destruction was shown on CT image. All masses were shown clear margin on MRI, two cases were homogeneous iso-intensity on T1WI, and one case was heterogeneous slightly hyper-intensity. One case demonstrated iso-intensity on T2WI, and the other two were shown slightly hyper-intensity. Two cases were performed contrated enhance MRI scanning before operation, and both of them demonstrated obvious homogeneous enhancement. DWI was performed on two cases and showed slightly hyper-intensity. Conclusion: Plasmacytoma located in the spheno-clival region with multiple myeloma is rare. If patients only show up with neurological symptoms, it needs to differential with other tumors frequently occur in this area. To combine analysing its characteristic appearance of MRI with clinical features and laboratory examinations ways would be helpful to improve the diagnostic accuracy, and final diagnosis need to be confirmed by pathological biopsy.
翁艺菲,戚荣丰,卢光明. 多发性骨髓瘤伴蝶鞍斜坡区浆细胞瘤CT及MRI表现(附3例报告及文献复习)[J]. 中国临床医学影像杂志, 2016, 27(8): 580-583.
WENG Yi-fei, QI Rong-feng, LU Guang-ming. CT and MRI features of multiple myeloma associated with plasmacytoma located in the spheno-clival region: three cases and literature review. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(8): 580-583.
[1]Al-Sobhi E, Osoba AO, Karar A, et al. Multiple myeloma of the central nervous system: a clinicopathological review[J]. East Mediterr Health J, 2009, 15(6): 1570-1579.
[2]Gagliardi F, Losa M, Boari N, et al. Solitary clival plasmocytomas: misleading clinical and radiological features of a rare pathology with a specific biological behaviour[J]. Acta Neurochir, 2013, 155(10): 1849-1856.
[3]Guinto-Balanzar G, Abdo-Toro M, Arechiga-Ramos N, et al. Plasma cell tumor of the clivus: report of two cases[J]. Cir Cir, 2012, 80(2): 171-176.
[4]Wein RO, Popat SR, Doerr TD, et al. Plasma cell tumors of the skull base: four case reports and literature review[J]. Skull Base, 2002, 12(2): 77-86.
[5]刘娅,孙建军,李厚恩,等. 累及蝶窦的多发性骨髓瘤的临床特点与分析[J]. 临床耳鼻咽喉头颈外科杂志,2013,27(5):230-232.
[6]张冲. 颅底孤立性骨浆细胞瘤的影像表现特征及鉴别诊断[J]. 中国医学影像学杂志,2015,27(1):34-36.
[7]Brannan SO, Matthews BN, Savant V, et al. Solitary intracranial extra-osseous plasmacytoma presenting with ophthalmic signs[J]. J Neuroophthalmol, 2003, 23(4): 268-271.
[8]Sabattini E, Bacci F, Sagramoso C, et al. WHO classification of tumours of haematopoietic and lymphoid tissues in 2008: an overview[J]. Pathologica, 2010, 102(3): 83-87.
[9]Cerase A, Tarantino A, Gozzetti A, et al. Intracranial involvement in plasmacytomas and multiple myeloma: a pictorial essay[J]. Neuroradiology, 2008, 50(8): 665-674.
[10]Liu ZY, Qi XQ, Wu XJ, et al. Solitary intracranial plasmacytoma located in the spheno-clival region mimicking chordoma: a case report[J]. J Int Med Res, 2010, 38(5): 1868-1875.
[11]Mohyeldin A, Prevedello DM, Jamshidi AO, et al. Nuances in the treatment of malignant tumors of the clival and petroclival region[J]. Int Arch Otorhinolaryngol, 2014, 18(2): 157-172.