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Given the existence of meningeal myelomatosis, a spine MRI was requested that ruled out spread to this level.Figure 1: MRI showing right solid extra-axial parieto-occipital lesion with typical characteristics of meningeal myelomatosis.A 66-year-old male patient presented with a history of liver transplant in 1993 due to severe acute hepatic insufficiency.Six months after transplant, he developed acute rejection with Epstein–Barr virus (EBV) viremia, requiring aggressive immunosuppression with cyclosporine and corticosteroids.The tumor adapted to the underlying brain surface showing adjacent pachymeningeal enhancement with focal spread through leptomeninges (Figure 1).A biopsy of the cranial lesion was conducted on November 12, 2015, with pathological diagnosis of plasmacytoma (Figure 2).
This study revealed a right solid extra-axial parieto-occipital lesion with typical characteristics of meningeal myelomatosis.
Extramedullary plasmacytomas can arise without evidence of multiple myeloma or also in patients with multiple myeloma at any time during the course of the disease .
Extramedullary plasmacytoma appears most frequently in head and neck locations , although cases have also been reported in the upper aerodigestive tract, gastrointestinal tract, urinary bladder, central nervous system, thyroids, breast, testicles, parotid gland, lymph nodes, and skin.
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Here, we describe the case of a 66-year-old male diagnosed with multiple myeloma who presented with generalized tonic-clonic seizures.
Because of this, we started concomitant therapy with radiotherapy and lenalidomide, but the patient has a poor response to treatment and died few weeks after its initiation.