<b>稀な頭蓋骨形質細胞腫の2例 </b>

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  • <b>Two case reports of rare cranial plasmacytomas </b>

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Multiple myeloma（MM） is a systemic plasmacytosis, with a poor prognosis, which generally causes death within an average of two to three years because of infection and renal failure. Males in their seventh decade are the most likely to develop the disease, and comprise about 10% of all cases of hematopoietic system malignant neoplasms[5]. The characteristic findings of MM that can be used for a diagnosis include the frequent appearance of “punched-out” lesions, such as, skull lesions anemia and increased plasmacytoma（>10%） in the bone marrow. However, the positive rate of various examinations is 70〜90% , and all findings may not be all present. According to the study reported by Okuda et al of 30 patients who harbored a huge mass in their skull, although the average age was 61 years old （36-62）, which was similar to MM, there were eight males and 22 females, and this elderly female dominance was not typical of MM. That prognosis is uneven, but generally poor. Approximately half of all patients died, and the one-year survival rate for such patients was around 50%（4）. In the cases able to undergo tumor removal, the prognosis at 1〜2 years tends to be better than the nonsurgical cases. When these tumors, especially those in the convexity area, can be removed, a surgical strategy is recommended. In non-surgical cases and for postoperative treatment, radiation and chemotherapy are recommended, because these can provide at least temporary responses. However, the treatment often requires two to six, months to induce tumor disappearance, so some neurological deficits may take a long time to resolve, or may never resolve completely （4）. However, despite the better prognosis following surgery, an operation is considered to be contraindicated when there is cerebral spinal fluid dissemination. Although case 1 in this paper was a very rare SPB arising from a centered sphenoid bone, no bone marrow abnormalities were found in a systemic examination. Because solitary SMM was diagnosed in case1, radiation and chemotherapy were added. Because case 2 was diagnosed to have a pure SPB, additional therapies were not t added. Both of our cases were solitary cases. Though they are both still alive and have had a good course strict observation especially in case 2, will be needed.

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