Multiple myeloma presenting as an intracranial plasmacytoma: a case report

Multiple myeloma presenting as an intracranial tumor (plasmacytoma) is very rare. An 81-year-old woman was admitted to our hospital because of gait disturbance. A blood laboratory test revealed a mildly increased lactate dehydrogenase (236 IU/L) and glucose (121 mg/dl). Blood protein fractions were normal. Brain computed tomography and magnetic resonance imaging revealed an intracranial mass (5 × 4 × 3 cm) in the brain base next to the clavus, and it was clinically diagnosed as chordoma. An excision of the brain tumor was performed. Imaging modalities including ultrasound, x-ray, computed tomography, magnetic resonance imaging and positron emission tomography did not reveal any tumors other than the brain tumor. The tumor was soft, fragile, and bloody. Microscopically, a monotonous proliferation of atypical plasma cells with hyperchromatic nuclei was recognized. Histochemically, the tumor cells were pyroninophilic and the congo-red stain revealed amyloidosis. Immunohistochemically, the tumor cells were positive for κ-chain and negative for cytokeratin, epithelial membrane antigen, vimentin, CD45, CD20, CD45RO, λ-chain, IgM, IgA, IgG, synaptophysin, chromogranin, S100 protein, desmin, α-smooth muscle antigen, myoglobin, p53 protein, and glial fibrillary acidic protein. The Ki-67 labeling was 11%. Intracranial plasmacytoma was pathologically diagnosed. The patient was treated by adjuvant chemoradiation, and entered into the complete remission stage. However, multiple metastases emerged in the vertebral bones and ribs six months after the remission. A diagnosis of multiple myeloma was made. The urine revealed Bence-Jones protein of monoclonal IgG κ-chain type, but blood M protein was not recognized. The patient's condition gradually deteriorated. The patient died of respiratory failure due to bronchopneumonia 18 months after the admission. The present case indicates that multiple myeloma may manifest as an intracranial brain tumor (plasmacytoma)

E-learning: mercato e modelli di business

I principali scopi dello studio sono:\ud - analizzare il settore dell'e-learning in Italia\ud - individuare gli attori presenti sul mercato e la catena del valore del settore\ud - individuare quali relazioni contrattuali tra fornitori di tecnologia e fornitori di contenuti possono risultare strategicamente rilevanti

Secondary fibrosarcoma of the brain stem treated with cyclophosphamide and Imatinib

Radiation-induced midbrain fibrosarcoma is a rare, highly aggressive tumor, which is associated with poor prognosis. We present the case of a 48-year old man with brainstem fibrosarcoma 20 years following radiation therapy received for a pituitary tumor. We discuss this case in the context of the diagnostic criteria for these tumors, and previous reports of secondary and primary sarcomas of the central nervous system

Suprasellar Mass

Blurred vision ODA 15-year old male with progressive blurred vision OD.VA: Best-corrected, 20/30 OD, 20/25 OSCTGlial tumor composed of astrocytesSurgeryAttache

Homonymous Hemianopia, Dementia and Elevated Sedimentation Rate

Distorted visionA 74-year old male with a complaint of distorted vision. Previous history significant for an episode of Bell palsy, recurring abdominal pain, intermittent microscopic hematuria and fever of unknown origin.Left homonomous para-central quadrantanopsiaCTHypodense lesion in right occipital area contributing to visual field defect; Atheromatous plaques in arterial liningsSurgeryN/

Foster-Kennedy Syndrome

Headache; Progressive loss of vision ODA 61-year old female with a 5-year history of diminishing vision associated with headache. Previous history significant for hypertension and congestive heart failure both of which were controlled. Cholecystectomy twenty years earlier.VA: 20/40 OD, 20/20 OS; Exophthalmometry: 18 OD, 16.5 OSCTMitotic plasma cells and lymphocytesCorticosteroidsN/

Galactorrhea and Ophthalmoplegia

Left lower facial weakness; Diplopia; Cognitive deficitsA 46-year old male evaluated for dementia and an eye movement disorder. Previous history significant for recurrent epistaxis, impotence and vertical gaze palsy.Gaze palsy; Conjunctivitis sicca; Absent optokinetic nystagmusRISA scanHepatic inflammation; Vascular calcification of right superior mediastinumCortocosteroids; Antifungal agents; anti-bacterial agentsN/

Effects of Slash Pile Burning after Restoring Conifer- Encroached Aspen

Removal of conifers encroaching aspen stands has been advocated and is being practiced in the Lake Tahoe Basin (EIP Project #10080: Aspen Community Restoration Projects). In remote and roadless areas, thinning of conifers is generating large volumes of wood and pile burning is currently being implemented to handle this biomass on site. However, the effects of pile burning on aspen are unknown, and there is an urgent need for guidelines to support design of thinning treatment prescriptions; specifically burn pile size and safe distances from live aspen trees of any size to prevent injury

Epithelioid Malignant Melanoma

LPO ODA 49-year old female with a history of subacute, painless loss of vision ODVA: LPO OD, 20/20 OS; IOP: 50 ODN/AEpithelioid malignant melanomaSteroids; SurgeryN/