Sellar Solitary Plasmacytoma Progressing to Multiple Myeloma

Sellar plasmacytoma is a rare cause of sellar lesions. Preoperative diagnosis remains a challenge. We present a 34-year-old Chinese woman with a 25-day history of headache and diplopia. A physical examination revealed incomplete left abducens nerve palsy. The initial diagnosis was invasive pituitary adenoma. The patient’s condition deteriorated suddenly the day before the arranged operating date, with the hemoglobin level declining from 113 g/L to 70 g/L. The operation was cancelled and further studies confirmed the diagnosis of sellar solitary plasmacytoma that progressed to multiple myeloma. After undergoing radiotherapy, high-dose chemotherapy, and autologous peripheral blood stem cell transplantation, complete remission was achieved on 4 years follow-up. We reviewed the pertinent literature and reached the following conclusions: sellar plasmacytomas with development of multiple myeloma on follow-up more likely happened in men than in women; and if the sellar plasmacytoma does not compress the cranial nerve, transsphenoidal resection should be cautious because the systemic treatment with radiotherapy, chemotherapy, and autologous peripheral blood stem cell transplantation may be more effective with little invasion. (Medicine 93(11):e58) Abbreviations: APBSCT = autologous peripheral blood stem cell mputed tomography scanning, MM = = magnetic resonance imaging, RT = ed: June 22, 2014; accepted: July 1, 2014. rosurgery, First Affiliated Hospital of Fujian Fujian, China (C-ZJ, Q-SL, X-YW, C-YW, ang, Department of Neurosurgery, First n Medical University, 20 Chazhong Road, , People’s Republic of China (e-mail: ). qually to this paper. upported by the Key Clinical Specialty Program of Fujian, People’s Republic of of interest to disclose. Kluwer Health | Lippincott Williams & ess article distributed under the terms of the n-NonCommercial-ShareAlike 4.0 License, ix, tweak, and build upon the work nonauthor is credited and the new creations are rms.