Extramedullary Multiple Myeloma Presenting as a Pituitary Mass Lesion

Abstract

Introduction:

A plasmocytoma involving the pituitary gland is an extremely rare entity, with approximately 22 cases of solitary myeloma or multiple myeloma presenting with sellar mass reported in the literature so far.

Case report:

Here, we report the case of a 71-year-old female patient affected by an extramedullary IgG-lambda multiple myeloma presenting as a pituitary mass lesion. We summarize the diagnostic approaches that confirmed the diagnosis of multiple myeloma and describe treatment outcome after therapy.

Discussion:

Intrasellar plasmocytoma though rare, should be considered in the differential diagnosis of a pituitary mass lesion, since associated with different therapeutic and prognostic implications. Physicians should be alert for intrasellar plasma cell tumors in case of well preserved anterior pituitary function in combination with cranial nerve neuropathies and sellar destruction.

Key words

extramedullary multiple myeloma - pituitary mass - case report

• References

• 1 Raab MS, Podar K, Breitkreutz I et al. Multiple myeloma. Lancet 2009; 374: 324-339
• 2 Yaman E, Benekli M, Coskun U et al. Intrasellar plasmacytoma: an unusual presentation of multiple myeloma. Acta Neurochir (Wien) 2008; 150: 921-924; discussion 924
• 3 Rivera J, Alves S, Bianchi CC et al. An unusual collision tumor comprising a prolactinoma and a plasmocytoma originating from the sellar region. Pituitary 2010 13: 189-193
• 4 Sinnott BP, Hatipoglu B, Sarne DH. Intrasellar plasmacytoma presenting as a non-functional invasive pituitary macro-adenoma: case report & literature review. Pituitary 2006; 9: 65-72
• 5 McLaughlin DM, Gray WJ, Jones FG et al. Plasmacytoma: an unusual cause of a pituitary mass lesion. A case report and a review of the literature. Pituitary 2004; 7: 179-181
• 6 Evans PJ, Jones MK, Hall R et al. Pituitary function with a solitary intrasellar plasmacytoma. Postgrad Med J 1985; 61: 513-514
• 7 Huang SY, Yao M, Tang JL et al. Clinical significance of cytogenetics and interphase fluorescence in situ hybridization analysis in newly diagnosed multiple myeloma in Taiwan. Ann Oncol 2005; 16: 1530-1538
• 8 Chang H, Qi C, Yi QL et al. p53 gene deletion detected by fluorescence in situ hybridization is an adverse prognostic factor for patients with multiple myeloma following autologous stem cell transplantation. Blood 2005; 105: 358-360
• 9 Holland J, Trenkner DA, Wasserman TH et al. Plasmacytoma. Treatment results and conversion to myeloma. Cancer 1992; 69: 1513-1517
• 10 Pitini V, Arrigo C, Alafaci C et al. Extramedullary plasmacytoma presented as a non-functional invasive pituitary macro-adenoma. J Neurooncol 2008; 88: 227-229
• 11 Estopinan V, Riobo P, Fernandez G et al. Intrasellar plasmacytoma simulating a pituitary adenoma. Med Clin (Barc) 1987; 89: 128