Guinto-Balanzar Gerardo, Abdo-Toro Miguel, Aréchiga-Ramos Norma, Leal-Ortega Roberto, Zepeda-Fernández Erick, Nambo-Lucio María de Jesús
Neurocirugía del Hospital de Especialidades del Centro Médico Nacional Siglo XXI, México, Distrito Federal, Mexico.
Cir Cir. 2012 Mar-Apr;80(2):171-6.
Plasma cell tumor only rarely affects the cranium and may be found as an isolated lesion or as a part of multiple myeloma. In this review we present the clinical and radiological characteristics and analyze the evolution of two cases of this tumor located at the skull base, specifically in the clivus and sellar region. We also present a brief review of the literature.
Case #1: The patient was a 66-year-old female with a solitary plasmacytoma of the bone (the isolated form of plasma cell tumor) that was totally removed. Case #2: The patient was a 61-year-old male with the diffuse form of this disease who was submitted to subtotal removal. In both patients, adjuvant treatment based on radiotherapy and chemotherapy was proposed; however, only one patient (Case #2) accepted adjuvant treatment and had a very favorable result. Most clinical symptoms disappeared and the patient is currently alive and with a very good quality of life (>3-year follow-up). The other patient (Case #1), despite the presence of the localized form of the disease, died 3 months after diagnosis.
Early diagnosis and removal of as much of the tumor as possible, but mainly the opportune indication of adjuvant treatment with radiotherapy and chemotherapy, are the keys to management of these cases.
浆细胞瘤很少累及颅骨，可表现为孤立性病变或作为多发性骨髓瘤的一部分。在本综述中，我们介绍了位于颅底，特别是斜坡和鞍区的两例该肿瘤的临床和影像学特征，并分析其病情演变。我们还对相关文献进行了简要回顾。
病例1：患者为一名66岁女性，患有骨孤立性浆细胞瘤（浆细胞瘤的孤立形式），肿瘤被完全切除。病例2：患者为一名61岁男性，患有该疾病的弥漫形式，接受了次全切除。在这两名患者中，均建议进行基于放疗和化疗的辅助治疗；然而，只有一名患者（病例2）接受了辅助治疗，且效果非常良好。大多数临床症状消失，该患者目前仍然存活，生活质量很高（随访超过3年）。另一名患者（病例1），尽管患有局限性疾病，但在诊断后3个月死亡。
早期诊断并尽可能多地切除肿瘤，但主要是适时采用放疗和化疗进行辅助治疗，是这些病例治疗的关键。
