Central nervous system myelomatosis with optic neuropathy and intramedullary spinal cord compression responding to radiation therapy

Central nervous system (CNS) involvement by multiple myeloma is a rare complication that occurs in less than 1% of cases. The purpose of this report is to highlight the unique presentation and treatment of a patient with CNS myelomatosis. A 58-year-old Caucasian woman with multiple myeloma developed...

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Bibliographic Details
Published in:Japanese journal of radiology 2011-08, Vol.29 (7), p.513-516
Main Authors: Riley, Jenny M., Russo, James K., Shipp, Allison, Alsharif, Mariam, Jenrette, Joseph M.
Format: Article
Language:English
Subjects:
Case Report
Central Nervous System Neoplasms - complications
Central Nervous System Neoplasms - diagnosis
Central Nervous System Neoplasms - radiotherapy
Dexamethasone - therapeutic use
Female
Glucocorticoids - therapeutic use
Humans
Imaging
Magnetic Resonance Imaging
Medicine
Medicine & Public Health
Middle Aged
Multiple Myeloma - complications
Multiple Myeloma - radiotherapy
Nuclear Medicine
Optic Nerve Diseases - diagnosis
Optic Nerve Diseases - drug therapy
Optic Nerve Diseases - etiology
Optic Nerve Diseases - radiotherapy
Prednisone - therapeutic use
Radiology
Radiotherapy
Spinal Cord Compression - diagnosis
Spinal Cord Compression - drug therapy
Spinal Cord Compression - etiology
Spinal Cord Compression - radiotherapy
Spinal Puncture
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Description
Summary:Central nervous system (CNS) involvement by multiple myeloma is a rare complication that occurs in less than 1% of cases. The purpose of this report is to highlight the unique presentation and treatment of a patient with CNS myelomatosis. A 58-year-old Caucasian woman with multiple myeloma developed subacute vision loss bilaterally and was found to have plasma cells in her cerebrospinal fluid. Using a helmet field to 25 Gy in 10 fractions, her vision was stabilized with radiotherapy. After developing right upper extremity numbness and weakness, magnetic resonance imaging revealed intramedullary spinal cord lesions from C5 to C7. She received radiotherapy to 25 Gy in 10 fractions from C4 to T1, with improvement in upper extremity strength after 15 Gy. Although CNS involvement by multiple myeloma is a rare complication, increasing awareness is necessary for clinicians to consider meningeal myelomatosis in patients with this neoplasm.
ISSN:1867-1071
1867-108X
DOI:10.1007/s11604-011-0577-7