颅骨浆细胞肿瘤1例  

Plasma cell tumor of the skull: a case report

作　　者：万豪杰 韩锋 杨华 杨明 罗登建 黄睿 陈伟 WAN Hao-jie;HAN Feng;YANG Hua;YANG Ming;LUO Deng-jian;HUANG Rui;CHEN Wei(School of Medicine,Guizhou Medical University,Guiyang 550025,China;Department of Neurosurgery,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]贵州医科大学临床医学院,贵阳550025 [2]贵州医科大学附属医院神经外科,贵阳550004

出　　处：《中国临床神经外科杂志》2024年第2期123-125,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：浆细胞瘤又称骨髓瘤,来源于骨髓内的浆细胞。颅骨浆细胞肿瘤只占髓外浆细胞肿瘤的极少部分,属临床罕见疾病。本文报道1例颅骨将细胞肿瘤,62岁女性,因头部包块伴疼痛不适6个月余入院。额部头皮包块大小约1.0cm×2.0cm,质地韧,界限不清,轻微压痛。颅脑CT平扫发现颅骨多发骨质破坏并额部软组织结节。颅脑MRI平扫+增强发现颅骨多发骨质破坏区并局部软组织结节形成。术前考虑嗜酸性肉芽肿。完善术前准备后,予以颅骨病损切除+颅骨成形术治疗,全切除额部病灶,术后病理检查证实为浆细胞肿瘤。术后规律行达雷妥尤单抗靶向治疗+伊沙佐米化疗,术后16个月复查颅脑MRI平扫未发现肿瘤复发。术后31个月电话随访显示,病人的右下肢偶有疼痛,病人可拄拐行走。总之,颅骨浆细胞肿瘤极为少见,影像学检查可为手术治疗提供定位诊断,但病理检查仍是诊断金标准,术后结合病理检查结果进行放化疗,可改善病人预后。Plasmacytoma,also known as myeloma,is derived from plasma cells in the bone marrow.Skull plasma cell tumors account for only a small part of extramedullary plasma cell tumors,which is a rare disease in clinic.This paper reported a case of skull plasma cell tumor,a 62-year-old female,who was admitted to hospital due to head mass accompanied by pain and discomfort for more than 6 months.The size of the frontal scalp mass was about 1.0 cm×2.0 cm,with tough texture,unclear boundary,and slight tenderness.The CT found multiple bone destruction of the skull and frontal soft tissue nodules.The plain scan+contrast-enhanceed MR images found multiple bone destruction areas of the skull and local soft tissue nodules.Eosinophilic granuloma was considered before operation.After completing preoperative preparation,skull lesion resection+cranioplasty was performed,and the total resection of the frontal lesions was confirmed by postoperative pathological examination as plasma cell tumor.After the regular treatment of daratumumab targeted therapy+ixazomib chemotherapy,no tumor recurrence was found in the reexamination of plain scan MR images 16 months after the operation.A telephone follow-up at 31 months postoperatively showed that the patient had occasional pain in the right lower limb and could walk with a crutch.In summary,skull plasma cell tumors are extremely rare,imaging examination can provide localization diagnosis for surgical treatment,but pathological examination is still the gold standard for diagnosis,postoperative radiotherapy and chemotherapy combined with pathological examination results can improve the prognosis of patients.

关 键 词：颅骨肿瘤 浆细胞瘤 骨髓瘤 显微手术 疗效 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]