Leptomeningeal myelomatosis

Case contributed by Bruno Di Muzio
Diagnosis probable

Presentation

Know multiple myeloma patient presenting with progressive neurological deterioration.

Patient Data

Age: 55 years
Gender: Male

MRI Brain

mri

Multiple foci of leptomeningeal nodular enhancement scattered throughout the brain, in particular along the frontal lobes and cerebellar folia. The brain is otherwise unremarkable. Enhancing well-defined nodules in the scalp. 

Case Discussion

This patient has been reported to have malignant plasma cells in their cerebrospinal fluid, which makes the leptomeningeal nodular enhancement presumed to represent CNS manifestations of his known multiple myeloma. The multiple enhancing scalp nodules are nonspecific, possibly representing cutaneous deposits of plasma cells, but we do not have a feedback of the histological analysis of those lesions by the time this case has been uploaded. 

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