Takano K, Ohgami S, Yonemasu Y, Fukuda H, Nakai H, Tomabechi M, Kawata M, Takemori N
Department of Neurosurgery, Asahikawa Medical College, Japan.
No Shinkei Geka. 1991 Dec;19(12):1181-5.
A case of multiple myeloma forming an intracranial mass which invaded the skull base was reported. A 72-year-old woman was admitted to the hospital because of left oculomotor paresis. Plain craniograms showed multiple punched out lesions. A CT scan demonstrated a mass lesion, which was homogeneously slightly enhanced with contrast medium, in the middle cranial fossa. MRI, both T1 and T2 weighted images, showed an isodensity mass. In the carotid angiograms the tumor was fed by the right branches of the cavernous portion of the internal carotid artery and the maxillary artery. Laboratory data were as follows: ESR: 132mm/30min, serum TP: 9.0g/dl, IgG: 4670mg/dl, IgA: 430mg/dl, and urinary Bence-Jones protein was detected. Bone marrow biopsy of the illiac bone demonstrated myeloma cells. During hospitalization oculomotor paresis disappeared, and the patient was treated with intramuscular interferon-alpha. Multiple myeloma which invades the skull base is rare, and only 10 cases have been reported since 1977. Moreover, the biclonal type is only 0.5% of all multiple myelomas.
报告了一例多发性骨髓瘤形成颅内肿块并侵犯颅底的病例。一名72岁女性因左侧动眼神经麻痹入院。头颅平片显示多个筛孔状病变。CT扫描显示中颅窝有一个肿块，增强扫描后呈均匀轻度强化。MRI的T1加权像和T2加权像均显示等密度肿块。颈动脉血管造影显示肿瘤由颈内动脉海绵窦段右支和上颌动脉供血。实验室检查数据如下：血沉：132mm/30分钟，血清总蛋白：9.0g/dl，免疫球蛋白G：4670mg/dl，免疫球蛋白A：430mg/dl，尿本-周蛋白阳性。髂骨骨髓活检发现骨髓瘤细胞。住院期间动眼神经麻痹消失，患者接受了肌肉注射α-干扰素治疗。侵犯颅底的多发性骨髓瘤罕见，自1977年以来仅报告了10例。此外，双克隆型仅占所有多发性骨髓瘤的0.5%。
