Bakar Bulent, Tekkok Ismail Hakki
Department of Neurosurgery, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey.
Turk Neurosurg. 2012;22(1):95-8. doi: 10.5137/1019-5149.JTN.2788-09.2.
Plasma cell tumours include solitary plasmocytoma, multiple plasmocytoma and multiple myeloma. Herein we report a case of plasmocytoma of the skull.
A 49 year-old-man suffered from amnesia, irritability and a rubbery swelling which was gradually increased approximately to 4-5 cm in diameter at the frontal vertex over a year. His neurological examination was normal. The skull direct X-ray revealed patchy destruction of the left frontal bone 10 cm in diameter. CT with bone windows showed relatively preserved but severely thinned inner table and irregularly destructed outer table. MR scan showed a hypervascular, mainly solid mass measuring 9x5.5x8.5 cms. Radical surgery consisting of total tumour extirpation was undertaken. Histopathological examination confirmed a plasmocytic proliferation. The postoperative period was uneventful and the patient was discharged on the 6th day postoperatively. Bone marrow sampling was scheduled to rule out multiple myeloma, but the patient committed suicide a week later for reasons not known to us.
Although the prognosis of a plasmocytoma is relatively good, this study demonstrated that patients with ventral frontal cortex tumour may have significantly worse mood pre- or postoperatively. Clinicians should therefore be careful in the follow-up period.
浆细胞肿瘤包括孤立性浆细胞瘤、多发性浆细胞瘤和多发性骨髓瘤。在此，我们报告一例颅骨浆细胞瘤病例。
一名49岁男性患有失忆、易怒症状，且在额顶部有一个橡皮样肿胀，一年多来逐渐增大至直径约4 - 5厘米。其神经系统检查正常。颅骨直接X线检查显示左额骨有直径10厘米的片状破坏。骨窗CT显示内板相对完整但严重变薄，外板不规则破坏。磁共振扫描显示一个血管丰富、主要为实性的肿块，大小为9×5.5×8.5厘米。进行了包括肿瘤全切的根治性手术。组织病理学检查证实为浆细胞增殖。术后恢复顺利，患者于术后第6天出院。计划进行骨髓穿刺以排除多发性骨髓瘤，但患者一周后自杀，原因不明。
尽管浆细胞瘤的预后相对较好，但本研究表明，额前叶腹侧皮质肿瘤患者术前或术后的情绪可能明显较差。因此，临床医生在随访期间应予以注意。
