Gamma knife radiosurgery for cavernous sinus plasmacytoma in a patient with breast cancer history.
BACKGROUND
Multiple myeloma (MM) presentation with cerebral mass lesion is unusual. Gamma knife radiosurgery for plasmacytoma has not been reported so far.


METHODS
We report a 70-year-old female with a medical history of infiltrative ductal carcinoma of the breast. She developed cavernous sinus syndrome (CSS) 5 months before admission to the hospital. The magnetic resonance imaging revealed an isointense solitary mass in the left cavernous sinus in noncontrast T1-weighted images. The lesion was highly enhancing with gadolinium-diethylenetriaminopentaacetic acid. She was operated by using Dolenc technique, and the tumor was partially resected. The pathological examination of the tumor tissue revealed a plasmacytoma. Systemic evaluation was positive for the diagnosis of MM. She underwent gamma knife radiosurgery for the residual cavernous sinus tumor. Chemotherapy with prednisolone and melphalan was given. Follow-up magnetic resonance images 6 months after the treatment demonstrated complete tumor disappearance. However, she died of sepsis 26 months after the diagnosis.


CONCLUSIONS
This is an unusual MM case with a history of breast cancer, which had CSS and which demonstrated an excellent response to gamma knife radiosurgery.
Peker
Selçuk
S
Department of Neurosurgery, Marmara University Neurological Sciences Institute, Istanbul, Turkey. peker@atlas.net.tr
Abacioğlu
Ufuk
U
Bayrakli
Fatih
F
Kiliç
Türker
T
Pamir
Mustafa Necmettin
MN
D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D001943:Breast Neoplasms / Q000453:epidemiology*; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology*; D002426:Cavernous Sinus / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D009101:Multiple Myeloma / Q000175:diagnosis / Q000453:epidemiology; D010954:Plasmacytoma / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016634:Radiosurgery; D016896:Treatment Outcome