Department of Neurosurgery, Arad Hospital, Tehran, Iran.
Department of Pathology, Arad Hospital, Tehran, Iran.
Arch Iran Med. 2014 Jul;17(7):526-8.
Plasma cell tumors of the skull base are rare in neurosurgical practice. True solitary osseous plasmacytoma of the skull base without development of multiple myeloma is extremely rare. We report a case of typical Gradenigo's syndrome, including left abducens nerve palsy, left facial pain and paresthesia in V1 and V2 distribution of trigeminal nerve caused by solitary osseous plasmacytoma of the left petrous apex. The patient was a 46-year-old man who presented with diplopia for two days. Magnetic resonance imaging (MRI) of the brain showed a hyperintense mass on T1-weighted images and slightly hypointense mass on T2-weighted images in the left petrous apex and left parasellar area. Through a left subtemporal middle fossa approach, subtotal resection of the lesion was performed. Histopathological examination of the lesion revealed plasmacytoma. The patient received 54 Gy radiation for the local tumor. Four months after radiation, the abducens palsy improved. Four years after treatment, the patient remained well with no symptoms or signs of local recurrence or progression to multiple myeloma.
颅底浆细胞瘤在神经外科实践中较为罕见。真正的颅底单发骨浆细胞瘤而无多发性骨髓瘤发展的情况极为罕见。我们报告了 1 例典型的 Gradenigo 综合征，包括左展神经麻痹，左面部疼痛和三叉神经第 1、2 支分布区的感觉异常，由左岩骨尖的单发骨浆细胞瘤引起。患者为 46 岁男性，因复视 2 天就诊。头颅磁共振成像（MRI）显示左岩骨尖和左鞍旁区 T1 加权图像上呈高信号，T2 加权图像上呈稍低信号的肿块。通过左侧颞下入路，行病变次全切除术。病变的组织病理学检查显示浆细胞瘤。患者接受了 54 Gy 的局部肿瘤放疗。放疗后 4 个月，外展神经麻痹改善。治疗 4 年后，患者情况良好，无局部复发或进展为多发性骨髓瘤的症状或体征。
