Chen Zupeng, Li Xu
Department of Neurosurgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2019 Apr;98(17):e15443. doi: 10.1097/MD.0000000000015443.
Plasmacytoma as the 1st presentation of skull tumors is a rare disorder. When it is combined with brain trauma or dramatic changes in intracranial pressure, patients are more prone to misdiagnosis.
A 67-year-old woman complaining of a headache presented with a history of head trauma for the past 1 hour. Emergency head computed tomography initially suggested an epidural hematoma.
Emergency surgery was performed to remove the intracranial hematoma, but a tumor-like mass was found during surgery, and pathologic assessment confirmed plasmacytoma. Surgery was difficult because of bleeding. The tumor was radically removed.
The patient underwent whole-brain radiotherapy and chemotherapy. She died 40 months after the surgery.
Epidural lesions found after a head injury may be assumed to be an epidural hematoma, leading to unnecessary surgery. Diseases such as hematomas, meningiomas, eosinophilic granulomas, bone metastases, and osteosarcomas must be considered.
浆细胞瘤作为颅骨肿瘤的首发表现是一种罕见的疾病。当它与脑外伤或颅内压急剧变化同时出现时，患者更容易被误诊。
一名67岁女性因头痛就诊，有过去1小时的头部外伤史。急诊头颅计算机断层扫描最初提示硬膜外血肿。
进行了急诊手术以清除颅内血肿，但手术中发现了一个肿瘤样肿块，病理评估证实为浆细胞瘤。由于出血，手术困难。肿瘤被根治性切除。
患者接受了全脑放疗和化疗。她在手术后40个月死亡。
头部受伤后发现的硬膜外病变可能被认为是硬膜外血肿，导致不必要的手术。必须考虑血肿、脑膜瘤、嗜酸性肉芽肿、骨转移瘤和骨肉瘤等疾病。
