Skull base plasmacytoma

A unique case of POEMS syndrome with a plasmacytoma causing craniocervical instability

Hannah Gilder, Meghan E. Murphy, Mohammed Ali Alvi, Panagiotis Kerezoudis, Daniel Shepherd, Patrick R. Maloney, Michael J Yaszemski, Jonathan M. Morris, Angela Dispenzieri, Jane M. Matsumoto, Mohamad Bydon

Research output: Contribution to journalArticle

Abstract

Introduction Plasmacytomas, considered to be the solitary counterparts of multiple myeloma, are neoplastic monoclonal plasma cell proliferations within soft tissue or bone. Plasmacytomas often present as a collection of findings known as POEMS-syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-Protein spike, and Skin changes). Case description We present a report of a 47 yo male diagnosed with POEMS-syndrome secondary to a skull base plasmacytoma. The mass resulted in marked instability of the cranio-cervical junction due to bony erosion. Following an induction course of chemotherapy, he showed clinical improvement with a marked reduction in tumor size and underwent an autologous peripheral blood stem cell transplant for systemic treatment of his POEMS-syndrome. Following completion of systemic treatment, he then underwent a definitive occipital-cervical fusion without complications. His neurologic exam upon dismissal was stable with subjective improvement in left upper extremity strength. Postoperative radiographs confirmed spinal alignment and pathological examination of a small biopsy from C1 revealed benign fibrous tissue. Conclusion To the best of our knowledge, this is the first report of a skull-base plasmacytoma associated with POEMS-syndrome, causing cranio-cervical instability. The approach of systemic therapy combined with temporary external fixation, followed by definitive occipital cervical fusion resulted in a good outcome for this patient.

Original languageEnglish (US)
Pages (from-to)254-257
Number of pages4
JournalJournal of Clinical Neuroscience
Volume47
DOIs
StatePublished - Jan 1 2018

Fingerprint

POEMS Syndrome
Plasmacytoma
Skull Base
Induction Chemotherapy
Plasma Cells
Multiple Myeloma
Upper Extremity
Nervous System
Therapeutics
Cell Proliferation
Transplants
Biopsy
Bone and Bones
Skin
Neoplasms
Proteins

Keywords

  • Craniocervical mass
  • Plasmacytoma
  • POEMS syndrome
  • Spinal oncology
  • Spine surgery

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Gilder, H., Murphy, M. E., Alvi, M. A., Kerezoudis, P., Shepherd, D., Maloney, P. R., ... Bydon, M. (2018). Skull base plasmacytoma: A unique case of POEMS syndrome with a plasmacytoma causing craniocervical instability. Journal of Clinical Neuroscience, 47, 254-257. https://doi.org/10.1016/j.jocn.2017.10.038

Skull base plasmacytoma : A unique case of POEMS syndrome with a plasmacytoma causing craniocervical instability. / Gilder, Hannah; Murphy, Meghan E.; Alvi, Mohammed Ali; Kerezoudis, Panagiotis; Shepherd, Daniel; Maloney, Patrick R.; Yaszemski, Michael J; Morris, Jonathan M.; Dispenzieri, Angela; Matsumoto, Jane M.; Bydon, Mohamad.

In: Journal of Clinical Neuroscience, Vol. 47, 01.01.2018, p. 254-257.

Research output: Contribution to journalArticle

Gilder, H, Murphy, ME, Alvi, MA, Kerezoudis, P, Shepherd, D, Maloney, PR, Yaszemski, MJ, Morris, JM, Dispenzieri, A, Matsumoto, JM & Bydon, M 2018, 'Skull base plasmacytoma: A unique case of POEMS syndrome with a plasmacytoma causing craniocervical instability', Journal of Clinical Neuroscience, vol. 47, pp. 254-257. https://doi.org/10.1016/j.jocn.2017.10.038
Gilder, Hannah ; Murphy, Meghan E. ; Alvi, Mohammed Ali ; Kerezoudis, Panagiotis ; Shepherd, Daniel ; Maloney, Patrick R. ; Yaszemski, Michael J ; Morris, Jonathan M. ; Dispenzieri, Angela ; Matsumoto, Jane M. ; Bydon, Mohamad. / Skull base plasmacytoma : A unique case of POEMS syndrome with a plasmacytoma causing craniocervical instability. In: Journal of Clinical Neuroscience. 2018 ; Vol. 47. pp. 254-257.
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