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Extramedullary plasmacytoma presenting as a solitary mass in the intracranial posterior fossa.

Daghighi MH, Poureisa M, Shimia M, Mazaheri-Khamene R, Daghighi S - Iran J Radiol (2012)

Bottom Line: Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise.Before this case report, only few cases have been reported in the literature.Nonetheless, this is the first report of posterior fossa EMP from Iran.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

ABSTRACT
A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran.

No MeSH data available.


Related in: MedlinePlus

A 37-year-old man with headache, large extraaxial iso-signal space occupying lesion on the right side of the posterior fossa with erosion of the internal table and compressive effect to the right cerebellar hemisphere and marked enhancement. A, CT image with erosion of the internal table; B, Axial FLAIR MRI with isosignal extra axial SOL at the right side of the posterior fossa; C, Coronal T1 WI without contrast; D, Sagittal T2 WI; E. Axial post-contrast T1 WI.
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fig561: A 37-year-old man with headache, large extraaxial iso-signal space occupying lesion on the right side of the posterior fossa with erosion of the internal table and compressive effect to the right cerebellar hemisphere and marked enhancement. A, CT image with erosion of the internal table; B, Axial FLAIR MRI with isosignal extra axial SOL at the right side of the posterior fossa; C, Coronal T1 WI without contrast; D, Sagittal T2 WI; E. Axial post-contrast T1 WI.

Mentions: A 37-year-old man was admitted in May 2011 with a 3-month history of headache refractory to pain medication. He had periodic medical examinations and displayed no abnormalities until the occipital headache began 3 months prior to admission. He denied a history of fatigue. Neurological examination was normal. CT revealed an extra axial mass on the right side of the posterior fossa. There was erosion of the inner table of the skull in CT scan images (Figure 1A). In the magnetic resonance imaging (MRI) (1.5 T) an isointense to gray matter mass, 55 × 35 × 31 mm in size was detected on FLAIR, T1 and T2 weighted images (WI) (Figure 1B-D). The vermis and the fourth ventricle were displaced to the left side and minimal hydrocephalus was also present. The mass enhanced severely after the injection of contrast media (Figure 1E). It had a similar appearance to meningioma. In addition, the site of the incidence was the location where meningioma commonly arises. Meningioma (the most probable), intracranial multiple myeloma (MM) and lymphoma were considered in the initial differential diagnosis list. Hospital admission laboratory workup revealed no hematological and biochemical abnormalities. Liver and kidney function tests were also unremarkable. He underwent surgery for the posterior fossa lesion. Suboccipital approach craniotomy was performed.


Extramedullary plasmacytoma presenting as a solitary mass in the intracranial posterior fossa.

Daghighi MH, Poureisa M, Shimia M, Mazaheri-Khamene R, Daghighi S - Iran J Radiol (2012)

A 37-year-old man with headache, large extraaxial iso-signal space occupying lesion on the right side of the posterior fossa with erosion of the internal table and compressive effect to the right cerebellar hemisphere and marked enhancement. A, CT image with erosion of the internal table; B, Axial FLAIR MRI with isosignal extra axial SOL at the right side of the posterior fossa; C, Coronal T1 WI without contrast; D, Sagittal T2 WI; E. Axial post-contrast T1 WI.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569557&req=5

fig561: A 37-year-old man with headache, large extraaxial iso-signal space occupying lesion on the right side of the posterior fossa with erosion of the internal table and compressive effect to the right cerebellar hemisphere and marked enhancement. A, CT image with erosion of the internal table; B, Axial FLAIR MRI with isosignal extra axial SOL at the right side of the posterior fossa; C, Coronal T1 WI without contrast; D, Sagittal T2 WI; E. Axial post-contrast T1 WI.
Mentions: A 37-year-old man was admitted in May 2011 with a 3-month history of headache refractory to pain medication. He had periodic medical examinations and displayed no abnormalities until the occipital headache began 3 months prior to admission. He denied a history of fatigue. Neurological examination was normal. CT revealed an extra axial mass on the right side of the posterior fossa. There was erosion of the inner table of the skull in CT scan images (Figure 1A). In the magnetic resonance imaging (MRI) (1.5 T) an isointense to gray matter mass, 55 × 35 × 31 mm in size was detected on FLAIR, T1 and T2 weighted images (WI) (Figure 1B-D). The vermis and the fourth ventricle were displaced to the left side and minimal hydrocephalus was also present. The mass enhanced severely after the injection of contrast media (Figure 1E). It had a similar appearance to meningioma. In addition, the site of the incidence was the location where meningioma commonly arises. Meningioma (the most probable), intracranial multiple myeloma (MM) and lymphoma were considered in the initial differential diagnosis list. Hospital admission laboratory workup revealed no hematological and biochemical abnormalities. Liver and kidney function tests were also unremarkable. He underwent surgery for the posterior fossa lesion. Suboccipital approach craniotomy was performed.

Bottom Line: Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise.Before this case report, only few cases have been reported in the literature.Nonetheless, this is the first report of posterior fossa EMP from Iran.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

ABSTRACT
A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran.

No MeSH data available.


Related in: MedlinePlus