A Very Rare Relaps Type in Multiple Myeloma: Leptomenıngeal and Cranial Involvement

Year 2024, Volume: 16 Issue: 1, 28 - 36, 30.04.2024

Orhan Ayyıldız , Songül Beskisiz

https://doi.org/10.56484/iamr.1455752

Abstract

Multiple myeloma is a hematological malignancy that develops as a result of clonal proliferation of plasma cells and progresses with remissions and relapses. It is clinically characterized by many symptoms and signs such as osteolytic bone lesions, hypercalcemia, renal dysfunction, hypergammaglobulinemia and anemia. However, involvement of the central nervous system, especially the leptomeningeal/cranial region, is a rare and prognostically important form of relapse of the disease. This case report discusses this rare clinical presentation, diagnostic approach, and treatment strategies of extramedullary involvement of multiple myeloma.

Keywords

Multipl Myeloma, Cranial involvement, Leptomeningeal involvement

References

• Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538-e548.
• Fonseca R, Barlogie B, Bataille R, et al. Genetics and cytogenetics of multiple myeloma: a workshop report. Cancer Res. 2004;64(4):1546-1558.
• Hideshima T, Bergsagel PL, Kuehl WM, Anderson KC. Advances in biology of multiple myeloma: clinical applications. Blood. 2004;104(3):607-618.
• Roodman GD. Pathogenesis of myeloma bone disease. Leukemia. 2009;23(3):435-441.
• Terpos E, Morgan G, Dimopoulos MA, et al. International Myeloma Working Group recommendations for the treatment of multiple myeloma-related bone disease. J Clin Oncol. 2013;31(18):2347-2357.
• Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7-30.
• Kyle RA, Rajkumar SV. Epidemiology of the plasma-cell disorders. Best Pract Res Clin Haematol. 2007;20(4):637-664.
• Waxman AJ, Mink PJ, Devesa SS, et al. Racial disparities in incidence and outcome in multiple myeloma: a population-based study. Blood. 2010;116(25):5501-5506.
• Roodman GD. Pathogenesis of myeloma bone disease. J Clin Oncol. 2009;27(6):968-974.
• Dimopoulos MA, Kastritis E, Rosinol L, Blade J, Ludwig H. Pathogenesis and treatment of renal failure in multiple myeloma. Leukemia. 2008;22(8):1485-1493.
• Paiva B, Orfao A, Dongen J. New criteria for response assessment: role of minimal residual disease in multiple myeloma. Blood. 2015
• Usmani SZ, Heuck C, Mitchell A, et al. Extramedullary disease portends poor prognosis in multiple myeloma and is over-represented in high-risk disease even in the era of novel agents. Haematologica. 2012;97(11):1761-1767.
• Fassas AB, Ward S, Muwalla F, et al. Myeloma of the central nervous system: strong association with unfavorable chromosomal abnormalities and other high-risk disease features. Leuk Lymphoma. 2004;45(2):291-300.
• Gozzetti A, Cerase A, Lotti F, et al. Extramedullary intracranial localization of multiple myeloma and treatment with novel agents: a retrospective survey of 50 patients. Cancer. 2012;118(6):1574-1584.