A 41-year-old man presented with complaints of severe headache and vomiting during the last 5 days. Neurological and systemic examination revealed no abnormality. A mass of 112x49 mm, which occupied the left frontoparietal parenchymal region, was evident on the T1 sequence of magnetic resonance imaging (Figure 1). This homogeneous contrasted mass displaced the left lateral ventricle and caused a shift of the mid-verge of the brain. The mass was totally removed (Figure 2). Pathological examination revealed a plasma cell dyscrasia with lambda monoclonality.
Figure 1. The mass occupied the left frontoparietal region, displacing the left lateral ventricle and causing a shift of the mid-verge of the brain.
Figure 2. Postoperative cranial magnetic resonance imaging.
Bone marrow biopsy was consistent with a clonal plasma cell accumulation of 5%. Two tiny M-protein peaks were detected on serum protein electrophoresis, which was compatible with immunoglobulin (Ig) G-and IgA-lambda monoclonal bands on serum immunofixation electrophoresis (Figure 3). There were no other plasmacytomas or lytic lesions detected with positron emission tomography-computed tomography imaging. The patient was diagnosed with a solitary plasmacytoma and treated with radiotherapy only. He had no complaints at the sixth month after diagnosis.
Figure 3. M-protein peaks on serum protein electrophoresis and monoclonal bands on immunofixation electrophoresis are depicted. Ig: Immunoglobulin.
Footnotes
Conflict of Interest: The authors of this paper have no conflicts of interest, including specific financial interests, relationships, and/or affiliations relevant to the subject matter or materials included.