title: [Multiple myeloma presenting with multiple subcutaneous masses].
abstract: A 92-year-old female was admitted to our hospital with 2-months history of rapidly enlarging subcutaneous masses in the multiple skull's regions. Neurological examination in the admission showed slightly right hemiparesis. Skull X-P showed multiple osteolytic lesions, and CT showed high density masses. MRI revealed iso-intensity masses on both T1 and T2-weighted images. Gd-DTPA enhanced T1-weighted image showed masses with marked homogeneous enhancement like the dural tail sign in the dura adjacent to the tumors. The tumor in the right frontal subcutaneous region was partialy removed; this mass was diagnosed as multiple myeloma. Because the prognosis of such a case was very poor and she was older, we thought her quality of life (QOL) and she was conservatively treated. A case of multiple myeloma having plasmacytoma in multiple skull's regions was reported. Although 30 cases in the literature of multiple myeloma forming cranial or intracranial plasmacytoma were briefly reviewed, multiple lesion was not reported and we thought it as a very rare case. And if such a case was performed to remove all masses, we believed that three dimensional computed tomography images to distinguish the tumors from skull and skin (Perspective 3D-CT; SIEMES's Somatom Emotion 6 and Syngo) was very valuable for the preoperative evaluation of a surgical approach.
authors.affiliation: Department of Neurosurgery, Chikuhou Rosai Hospital, Fukuoka, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ohta
authors.forename: Seiichirou
authors.initials: S
authors.lastname: Kawano
authors.forename: Akira
authors.initials: A
authors.lastname: Yokota
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000473:pathology*; D012888:Skull Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019786:Gadolinium DTPA