Cerebral tumor with hemi-dural enhancement as unique presentation of multiple myeloma: A case report

• Published in: Brain & spine Vol. 4; p. 102730
• Main Authors: van Lanen, Rick H G J, Huijs, Sandra M H, Postma, Alida A, Haeren, Roel H L
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier 01.01.2024
• Subjects: Case Report; Dura mater; Intracranial; Multiple myeloma; Plasmacytoma; Intracranial; Dura mater; Case report; Plasmacytoma; Multiple myeloma
• ISSN: 2772-5294; 2772-5294
• DOI: 10.1016/j.bas.2023.102730

Intracranial multiple myeloma (MM) is a rare manifestation of MM, a malignant plasma cell disorder that primarily affects bone marrow. Dural involvement in MM is even rarer and can manifest as a dural mass. We present a case of MM presenting as an intracranial dural tumor with primary hemi-dural involvement. This case report aims to investigate the clinical presentation, diagnostic challenges, and treatment approaches for intracranial multiple myeloma, with a focus on the extensive hemi-dural thickening and enhancement seen in this case. A 73-year-old male presented with progressive dysphasia and weakness. MRI revealed a solid left frontal mass with significant mass-effect. Hemi-dural thickening and enhancement was present along with invasion of the skull. The patient underwent surgical resection of the tumor with dural and bone reconstruction. Histopathological examination confirmed MM diagnosis. Chemotherapy was started. Follow-up MRI showed complete tumor resection, but extensive hemi-dural thickening and enhancement persisted. Postoperative radiation therapy was considered. MM with primary dural involvement is rare and poses diagnostic challenges. Postoperative treatment involves chemotherapy, the role of surgery and radiotherapy is not established. The extensive hemi-dural thickening and enhancement observed in this case require further investigation, and a wait-and-scan policy was recommended instead of radiotherapy.