Alafaci Cetty, Grasso Giovanni, Conti Alfredo, Caffo Mariella, Salpietro Francesco Maria, Tomasello Francesco
University of Messina, Department of Neurosurgery, Messina, Italy.
Turk Neurosurg. 2014;24(2):272-5. doi: 10.5137/1019-5149.JTN.7049-12.0.
Cranial and intracranial involvement by myelomatous disease is relatively uncommon. Furthermore, systemic manifestations of multiple myeloma are present in the majority of these cases at the time of symptom onset. The authors report the case of a patient with serial appearance of multiple intracranial plasma cell tumor localizations as the first manifestations of a multiple myeloma. The patient was treated with CyberKnife radiosurgery for a lesion localized at the clivus and sella turcica with complete local control. With such a technique, based on high-dose conformality, the tumor was centered with an ablative dose of radiation and, at the same time, with a low dose spreading to the surrounding critical structures. The radiosensitivity of plasma cell tumors renders this treatment modality particularly advantageous for their localized manifestation. A technical description of this case is provided. To our knowledge, this is the first case of successful Cyberknife radiosurgery of multifocal intracranial plasmacytoma.
骨髓瘤疾病累及颅骨和颅内相对少见。此外，在大多数此类病例中，症状出现时多有多发性骨髓瘤的全身表现。作者报告了一例患者，其多发性颅内浆细胞瘤定位的系列表现为多发性骨髓瘤的首发表现。该患者接受了射波刀放射外科治疗，用于治疗位于斜坡和蝶鞍的病变，实现了完全局部控制。采用这种基于高剂量适形性的技术，肿瘤以消融剂量的辐射为中心，同时低剂量辐射扩散到周围关键结构。浆细胞瘤的放射敏感性使这种治疗方式对其局限性表现特别有利。本文提供了该病例的技术描述。据我们所知，这是首例成功应用射波刀放射外科治疗多灶性颅内浆细胞瘤的病例。
