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Dorsum sellae solitary plasmacytoma revealed by neuronavigation-guided biopsy

Dorsum sellae solitary plasmacytoma revealed by neuronavigation-guided biopsy . M. Neroni, G. Ricci, R. Gazzeri, e S. Esposito U.O.D. Neurosurgery, San Giovanni – Addolorata Hospital Rome. Introduction

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Dorsum sellae solitary plasmacytoma revealed by neuronavigation-guided biopsy

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  1. Dorsum sellae solitary plasmacytoma revealed by neuronavigation-guided biopsy M. Neroni, G. Ricci, R. Gazzeri, e S. Esposito U.O.D. Neurosurgery, San Giovanni – Addolorata Hospital Rome

  2. Introduction Occurrence of cranio-cervical extramedullary solitary plasma cell tumors (EMPs) represent 18% - Skull base represent a rare case of EMPs localization We report a case of dorsum sellae EMP

  3. Case Report A 64 y.o. cauc. man presenting with a complete right ophtalmoparesis MR showed parasellar lesion involving the CS and ICAs - Body scan (after the biopsy) was unable to demonstrate extracranial localization

  4. Trans-sphenoidal neuronav assisted approach Biopsy of the anterior intrasellar region of the tumor

  5. Intra-op histo exam revealed a plasma cell tumor Plasmacytomas are composed of a proliferation of abnormal plasma cells that exhibit monoclonal intracellular immunoglobulines with immunological staining techniques. Plasmacytoma is further classified into two groups: osseous (solitary plasmacytoma of bone) and non osseous (extramedullary plasmacytoma) primary lesions (3 Pancholi) .

  6. Conclusion A local irradiation is the primary mode of treatment for extramedullary plasmacytomas, then after the biopsy the patient received radiation (52 Gy) in association with VAD ( vincristin, adriamycine, dexamethasone). MRI performed after the therapy showed a reduction of the mass and the regression of the cranial nerve deficit. This case highlights the importance of obtaining a biopsy of skull base tumors to determine the appropriate treatment A plasmacytoma of the skull base has a high risk to progress to multiple myeloma over the years. (Ustuner, Pancholi). At nine months F.U. patient developed diffuse mieloma and 2 year after he died

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