International Journal of Hematology-Oncology and Stem Cell Research 2018. 12(1):8-13.

Multiple Cranial Nerve Palsy Concomitant with Leptomeningeal Involvement in Multiple Myeloma: A Case Report and Review of Literature
Neda Pak, Fatemeh Shakki Katouli, Amir Reza Radmard, Mohammad Hassan Shaki Katuli, Mohamad Mehdi Rezwanifar, Negar Sepehri Boroujeni


Neurologic symptoms are quite common in multiple myeloma, but direct invasion of central nervous system is extremely rare. Leptomeningeal multiple myeloma, as a rare neurological manifestation of multiple myeloma, presents with impairment of consciousness, cranial nerve palsies and convulsions. Here, we describe a 52-year- old male patient, known case of multiple myeloma, who presented with bilateral visual loss and difficulty in swallowing.


Multiple myeloma, Diagnosis, Neuroimaging

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Kyle RA, Rajkumar SV. Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma. Leukemia. 2009; 23(1):3-9.

Bladé J, de Larrea CF, Rosiñol L. Extramedullary involvement in multiple myeloma. Haematologica. 2012; 97(11):1618-9.

Yellu MR, Engel JM, Ghose A, et al. Overview of recent trends in diagnosis and management of leptomeningeal multiple myeloma. Hematol oncol. 2016.34(1):2-8.

Fassas AB, Muwalla F, Berryman T, et al. Myeloma of the central nervous system: association with high‐risk chromosomal abnormalities, plasmablastic morphology and extramedullary manifestations. Br of Haematol. 2002; 117(1):103-8.

Halczuk I, Iłzecka J, Stelmasiak Z. [Myelomatous meningitis: a case report]. Neurol Neurochir Pol. 1998. 33(6):1425-33.

Schluterman KO, Fassas AB, Van Hemert RL, et al. Multiple myeloma invasion of the central nervous system. Arch Neurol. 2004; 61(9):1423-9.

Kalita LK, Kalita C, Gogoi PK, et al. Multiple Myeloma Presenting As Third Cranial Nerve Palsy: A Rare Case Report. JEBMH. 2015; 2(15): 2375-2378.

Petersen SL, Wagner A, Gimsing P. Cerebral and meningeal multiple myeloma after autologous stem cell transplantation. A case report and review of the literature. Am J Hematol. 1999; 62(4):228-33.

Nieuwenhuizen L, Biesma DH. Central nervous system myelomatosis: review of the literature. Eur J Haematol. 2008; 80(1):1-9.

Lopes da Silva, R, Costa I, Prata M, et al. "Plasma cell meningitis: a rare neurological complication of multiple myeloma requiring a high index of suspicion." Acta Neurol Taiwan. 2011. 20(3): 209-12.

Bunn PJ, Schein PS, Banks PM, et al. Central nervous system complications in patients with diffuse histiocytic and undifferentiated lymphoma: leukemia revisited. Blood. 1976; 47(1):3-10.

Grossman SA, Krabak MJ. Leptomeningeal carcinomatosis. Cancer Treat Rev. 1999; 25(2):103-19.

Rosen ST, Aisner J, Makuch RW, et al. Carcinomatous leptomeningitis in small cell lung cancer: a clinicopathologic review of the National Cancer Institute experience. Medicine (Baltimore). 1982; 61 (1):45-53.

Boogerd W, Hart AA, van der Sande JJ, et al. Meningeal carcinomatosis in breast cancer. Prognostic factors and influence of treatment. Cancer. 1991; 67(6):1685-95.

Marini A, Carulli G, Lari T, et al. Myelomatous meningitis evaluated by multiparameter flow cytometry: report of a case and review of the literature. J Clin Exp Hematop. 2014; 54(2):129-36.

Méndez CE, Hwang BJ, Destian Set al. Intracranial multifocal dural involvement in multiple myeloma: case report and review of the literature. Clin Lymphoma Myeloma Leuk. 2010; 10(3):220-3.

Supko JG, Eder JP, Lynch TJ, et al. Pharmacokinetics of irinotecan and the proteasome inhibitor bortezomib in adult patients with solid malignancies. InProc Am Soc Clin Oncol. 2003; 22(1):136.

Schwartz R, Davidson T. Pharmacology, pharmacokinetics, and practical applications of bortezomib. Oncology (Williston Park). 2004; 18(14 Suppl 11):14-21.

Fairfield H, Falank C, Avery L, et al. Multiple myeloma in the marrow: pathogenesis and treatments. Ann N Y Acad Sci. 2016; 1364:32-51.

Woodruff RK, Ireton HJ. Multiple cranial nerve palsies as the presenting feature of meningeal myelomatosis. Cancer. 1982; 49(8):1710-2.

Leifer D, Grabowski T, Simonian N, et al. Leptomeningeal myelomatosis presenting with mental status changes and other neurologic findings. Cancer. 1992; 70(7):1899-904.

Pizzuti P, Pertuiset E, Chaumonnot F, et al. [Neuromeningeal sites of multiple myeloma: 3 cases and review of the literature]. Rev Med Interne. 1997; 18(8):646-51

Roddie P, Collie D, Johnson P. Myelomatous involvement of the dura mater: a rare complication of multiple myeloma. J Clin Pathol. 2000; 53(5):398-9.

Yeung SN, Paton KE, Dorovini-Zis K, et al. Histopathologic features of multiple myeloma involving the optic nerves. J Neuroophthalmol. 2008; 28(1):12-6.

Riley JM, Russo JK, Shipp A, et al. Central nervous system myelomatosis with optic neuropathy and intramedullary spinal cord compression responding to radiation therapy Jpn J Radiol. 2011; 29(7):513-6.

Grisold A, Weber C, Hainfellner J, et al. MRI negative meningeal myeloma with abducens nerve palsies responding to intrathecal chemotherapy. J Neurol Sci. 2014; 347(1-2):359-60.

Yilmaz SG, Ture G, Zengin MÖ, et al. Optic nerve and dura mater involvement as the first sign of multiple myeloma. Eur J Ophthalmol. 2015; 25(1):77-9.


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