Intracranial
plasmocytomas are a rare abnormality in a neurosurgeon's practice. The
plasmocytomas may originate from the skull bones or soft tissue intracranial structures; they may be solitary or occur as a manifestation of
multiple myeloma, this type being typical of most intracranial
plasmocytomas. Progression of solitary
plasmocytoma to
multiple myeloma is observed in a number of cases. Preoperative diagnosis involves computed tomography or magnetic resonance imaging; angiography is desirable. The final diagnosis of
plasmocytoma is chiefly based on a morphological study. Special immunohistochemical studies yield very promising results; these are likely to be of high prognostic value. Intracranial
plasmocytomas require a differential approach and a meticulous examination since the presence or absence of
multiple myeloma radically affects prognosis. There are well-defined predictors; however, it is appropriate that craniobasal
plasmocytomas show a worse prognosis than
plasmocytomas of the skull vault and more commonly progress to
multiple myeloma.
Plasmocytomas respond to
radiotherapy very well. The gold standard of treatment for
plasmocytoma is its total removal and adjuvant
radiation therapy; however, there is evidence for good results when it is partially removed and undergoes
radiotherapy or after radical surgery without subsequent radiation. The role of
chemotherapy has not been defined today.