title: Case study of intracerebral plasmacytoma as an initial presentation of multiple myeloma.
abstract: Cerebral involvement is an uncommon complication of multiple myeloma. We report on a 64-year-old man hospitalized for a partial seizure. MRI showed two intracerebral lesions, which proved to be plasmacytomas. After complete staging, we retained the diagnosis of immunoglobulin G lambda-type multiple myeloma with CNS involvement. Cytogenetic analysis of plasma cells detected a deletion in the p53 gene at 17p13.1. Despite cranial radiotherapy and systemic chemotherapy, the patient's disease progressed rapidly and he died five months after diagnosis. What makes this case unusual is that overt multiple myeloma had been absent before cerebral involvement was discovered. It confirms the extremely poor prognosis of patients with CNS myeloma even in the presence of aggressive treatment. Cytogenetic abnormalities could be a marker of chromosomal and genetic instability, conferring to multiple myeloma a more aggressive profile.
authors.affiliation: Department of Oncology, University Hospital CHUV , Lausanne, Switzerland.
authors.forename: Aurelia
authors.initials: A
authors.lastname: Wavre
authors.forename: Audrey S
authors.initials: AS
authors.lastname: Baur
authors.forename: Michael
authors.initials: M
authors.lastname: Betz
authors.forename: Dominique
authors.initials: D
authors.lastname: Mühlematter
authors.forename: Martine
authors.initials: M
authors.lastname: Jotterand
authors.forename: Khalil
authors.initials: K
authors.lastname: Zaman
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ketterer
mesh_terms: D001932:Brain Neoplasms / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology; D017809:Fatal Outcome; D017353:Gene Deletion; D016158:Genes, p53; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000235:genetics* / Q000473:pathology* / Q000628:therapy; D010954:Plasmacytoma / Q000235:genetics / Q000473:pathology* / Q000628:therapy