Extramedullary intracranial solitary plasmocytoma. Report of 2 cases

Multiple myeloma frequently affects the C.N.S with a high prevalence of spinal cord compression following vertebral neoplastic infiltration. On the other hand, solitary plasmacytomas, tumors that arise in a wide variety of locations due to the universal distribution of plasma cells, are infrequent within the cranial vault and rarely present as extramedullary lesions, arising from the intracranial soft tissues without affecting neighboring bony structures. Only 33 such cases have been reported in the medical literature. The authors report two additional cases of solitary intracranial, extramedullary plasmacytoma. Case 1.--54 year-old woman with a chief complaint of severe headache and behavioral changes of three months duration. C.N.S. imaging revealed a bifrontal mass lesion, arising from the anterior third of the falx cerebri. Case 2.--45 year old-man who complained of headache and blurred vision of a month duration C.N.S. imaging displayed a third ventricle mass lesion. In both cases the neuropathological diagnosis was extramedullary plasmacytoma. Postoperatively the confirmation of solitary intracranial plasmacytoma was achieved only after a thorough work-up to rule out the presence of neoplasm elsewhere in the body. Radiotherapy was given to both patients and follow-up has failed to reveal neoplastic disease 4 and 3 years, respectively, after the diagnosis.