title: Meningeal hematopoiesis causing exophthalmus and hemiparesis in myelofibrosis: effect of radiotherapy. A case report.
abstract: Meningeal myeloid metaplasia (MM) is very rarely observed in patients with myelofibrosis. We report the occurrence of meningeal MM causing exophthalmus and fever in a patient with myelofibrosis secondary to polycythemia vera. A computerized tomography (CT) scan showed multiple intracranial and intraorbital enhancing masses. A needle aspirate of retrobulbar space confirmed the diagnosis of extramedullary hematopoiesis. The patient subsequently developed a rapidly worsening tumor-like syndrome with hemiparesis, aphasia, and loss of sphinteric control. The administration of radiotherapy caused a complete and stable regression of clinical symptoms and a marked reduction of MM masses.
authors.affiliation: Department of Hematology, Catholic University, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Landolfi
authors.forename: C
authors.initials: C
authors.lastname: Colosimo
authors.forename: E
authors.initials: E
authors.lastname: De Candia
authors.forename: M A
authors.initials: MA
authors.lastname: Castellana
authors.forename: R
authors.initials: R
authors.lastname: De Cristofaro
authors.forename: L
authors.initials: L
authors.lastname: Trodella
authors.forename: G
authors.initials: G
authors.lastname: Leone
mesh_terms: D000328:Adult; D005094:Exophthalmos / Q000209:etiology*; D005260:Female; D006411:Hematopoiesis, Extramedullary; D006429:Hemiplegia / Q000209:etiology*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008578:Meninges / Q000000981:diagnostic imaging; D011087:Polycythemia Vera / Q000150:complications*; D055728:Primary Myelofibrosis / Q000150:complications* / Q000532:radiotherapy; D014057:Tomography, X-Ray Computed