Primary Cerebral Plasmacytoma: A Rare Case Report with Review of Literature

• Main Authors: Arun Kumar, Biswaranjan Nayak, Balappa Holeppagol Krishnamurthy, Sushant Kumar Patro, Prafulla Kumar Sahoo
• Format: Article
• Language: English
• Published: Thieme Medical Publishers, Inc. 2019-08-01
• Series: Indian Journal of Neurosurgery
• Subjects: solitary plasmacytoma; extramedullary plasmacytoma; solitary plasmacytoma of bone; multiple myeloma (mm)
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1696069
• ISSN: 2277-954X; 2277-9167

Solitary craniocerebral plasmacytoma is the least common form of extramedullary solitary plasmacytoma (SP). Cerebral SP is very rare. The world literature counts only seven intracranial cases. The authors report a case of cerebral tumor of SP in a 52-year-old female who presented to a hospital with headache and difficulty in walking for 6 months. Contrast-enhanced computed tomography (CECT) brain showed left occipital intracranial space occupying lesions (ICSOL) of size 26 mm × 14 mm adjacent to superior sagittal sinus with disproportionate perilesional edema and midline shift toward the right. She underwent gross total tumor excision with left fronto-temporo-parietal decompressive craniectomy. Microscopic sections showed highly cellular tumor infiltrating white matter and gray matter. Histopathology revealed plasmacytoma. These plasma cells were seen infiltrating the adjoining brain parenchyma. Immunohistochemistry study showed the following pattern of antigens: most of the cells were negative to CD138 antibody, and majority of cells were positive (++ to +++) to CD56 antibody, more groups of cells were positive to lambda antibody than KAPPA. Bone marrow biopsy showed only 1% polyclonal plasma cells. Whole body bone scan showed no evidence of any osteoblastic skeletal metastasis. The patient recovered well, and cranioplasty was done after 6 weeks. Conclusion Cerebral SP is rarely found in clinical practice and if diagnosed properly can save patients life. This case report would definitely address many unexplored facts about cerebral SP and set milestone in the field of clinical research.