Relapsed Multiple Myeloma Presenting with an Intracranial Plasmacytoma Mimicking a Convexity Meningioma

Abstract

A 67 year-old woman presented with pronounced headache and vomiting that had progressed over one week. One year ago, she had been diagnosed as having multiple myeloma and had been treated with first-line chemotherapy. Her physical examination revealed marked left-sided hemiparesis. On magnetic resonance imaging of the brain, a right-sided mass lesion that appeared to originate from the meninges was associated with intense oedema that resulted in left-sided shift of the midline structures. The presumptive diagnosis of a convexity meningioma was made. The patient underwent an emergency craniotomy with resection of the mass lesion and was diagnosed as having an intracranial plasmacytoma. The decision was made to proceed with radiation therapy. In the interim, the patient was diagnosed as having relapsed multiple myeloma and was treated with second-line chemotherapy accordingly. She was alive at the follow-up visit one year following surgery.