Skull base plasmacytoma: A unique case of POEMS syndrome with a plasmacytoma causing craniocervical instability

Hannah Gilder, Meghan E. Murphy, Mohammed Ali Alvi, Panagiotis Kerezoudis, Daniel Shepherd, Patrick R. Maloney, Michael J. Yaszemski, Jonathan M. Morris, Angela Dispenzieri, Jane M. Matsumoto, Mohamad Bydon

Research output: Contribution to journalArticlepeer-review


Introduction Plasmacytomas, considered to be the solitary counterparts of multiple myeloma, are neoplastic monoclonal plasma cell proliferations within soft tissue or bone. Plasmacytomas often present as a collection of findings known as POEMS-syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-Protein spike, and Skin changes). Case description We present a report of a 47 yo male diagnosed with POEMS-syndrome secondary to a skull base plasmacytoma. The mass resulted in marked instability of the cranio-cervical junction due to bony erosion. Following an induction course of chemotherapy, he showed clinical improvement with a marked reduction in tumor size and underwent an autologous peripheral blood stem cell transplant for systemic treatment of his POEMS-syndrome. Following completion of systemic treatment, he then underwent a definitive occipital-cervical fusion without complications. His neurologic exam upon dismissal was stable with subjective improvement in left upper extremity strength. Postoperative radiographs confirmed spinal alignment and pathological examination of a small biopsy from C1 revealed benign fibrous tissue. Conclusion To the best of our knowledge, this is the first report of a skull-base plasmacytoma associated with POEMS-syndrome, causing cranio-cervical instability. The approach of systemic therapy combined with temporary external fixation, followed by definitive occipital cervical fusion resulted in a good outcome for this patient.

Original languageEnglish (US)
Pages (from-to)254-257
Number of pages4
JournalJournal of Clinical Neuroscience
StatePublished - Jan 2018


  • Craniocervical mass
  • POEMS syndrome
  • Plasmacytoma
  • Spinal oncology
  • Spine surgery

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)


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