Foster-Kennedy syndrome caused by solitary intracranial plasmacytoma

doi:10.1016/S0090-3019(83)80014-7

Surgical Neurology

Volume 19, Issue 3, March 1983, Pages 267-272

https://doi.org/10.1016/S0090-3019(83)80014-7 Get rights and content

The first case of typical Foster-Kennedy syndrome, including decreased olfaction of the side of the optic atrophy due to a primary solitary intracranial extraskeletal plasmacytoma, is reported. Its appearance on a computed tomography scan was compatible with a meningioma or subdural hematoma. The patient demonstrated a chronic, corticosteroid-sensitive, relapsing optic neuropathy associated with an elevated sedimentation rate and a monoclonal gammopathy. The diagnosis, treatment, and prognosis of such tumors are reviewed.

References (45)

HirstLW et al.
Medulloblastoma causing a corticosteroid-responsive optic neuropathy
Am J Ophthalmol
(1980)
KanekoD et al.
Intracranial plasmacytoma arising from the dura mater
Surg Neurol
(1982)
KaminDF et al.
Solitary intracranial plasmacytoma mistaken for retrobulbar neuritis
Am J Ophthalmol
(1972)
KohliCM et al.
Solitary intracranial plasmacytoma
Surg Neurol
(1982)
SenelickRC et al.
Chromophobe adenoma masquerading as corticosteroid-responsive optic neuritis
Am J Ophthalmol
(1974)
ArmstrongE et al.
Two cases of multiple myeloma (plasmacytoma) with secondary deposits in the dura mater
J Pathol Bacteriol
(1946)
AtwehGF et al.
Intracranial solitary extraskeletal plasmacytoma resembling meningioma
Arch Neurol
(1982)
BatailleR et al.
Solitary myeloma: clinical and prognostic features of a review of 114 cases
Cancer
(1981)
BichelJ et al.
Notes on myeloma
Acta Radiol
(1938)
CarsonCP et al.
Plasma cell myeloma. A clinical pathologic and roentgenologic review of 90 cases
Am J Clin Pathol
(1955)

CastlemanB et al.

Case records of the Massachusetts General Hospital. Case 3-1973

N Engl J Med

(1973)

ChangSC et al.

Solitary plasmacytoma in the cranial cavity

J Neurosurg

(1970)

ChristophersonWM et al.

A re-evaluation of solitary plasma cell myeloma of bone

Cancer

(1950)

ClarkeE

Cranial and intracranial myelomas

Brain

(1954)

DodsonTA

Solitary extramedullary plasmacytoma of the head and neck

Trans Am Acad Ophthalmol Otolaryngol

(1975)

DolinS et al.

Extramedullary plasmacytoma

Am J Clin Pathol

(1956)

FrenchJD

Plasmacytoma of the hypothalamus

J Neuropathol Exp Neurol

(1947)

GadA et al.

Solitary dural plasmacytoma

Acta Pathol Microbiol Scand [A]

(1978)

GravanisMB et al.

Intracranial solitary plasmacytoma (abstr)

Am J Clin Pathol

(1969)

HedgesTR

Papilledema: Its recognition and relation to increased intracranial pressure

Surv Ophthalmol

(1975)

HolckS

Plasma cell granuloma of the thyroid

Cancer

(1981)

KanieN et al.

Solitary intracerebral plasmacytoma

Neurol Med Chir (Tokyo)

(1981)

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Solitary extramedullary (extraosseous) intracranial plasmacytoma. Report of a new case and review of the literature
2000, Neurocirugia
De acuerdo con algunos autores los plasmocitomas solitarios sólo constituyen un estadio en la evolución del mieloma múltiple. Sin embargo, otros afirman que estas lesiones representan entidades bien definidas las cuales responden favorablemente a la cirugía seguida de radioterapia y que acarrean un mejor pronóstico que las discrasias diseminadas de células plasmáticas. Presentamos el caso clínico de un varón de 44 años con historia de cefalea y convulsiones de dos meses de evolución en el que los estudios de neuroimágenes revelaron un tumor parietal derecho adherido a la duramadre, con apariencia de meningioma. La lesión fue extirpada quirúrgicamente y diagnosticada como plasmocitoma solitario después de descartar una neoplasia sistémica de células plasmáticas sobre la base de los resultados obtenidos en pruebas tales como determinación de proteína de Bence-Jones, aspiración y biopsia de médula ósea, examen radiológico simple y gammagrafía ósea. El paciente ha permanecido libre de tumor durante cuatro años y medio contados a partir de la extirpación quirúrgica. Se revisa la literatura relacionada con lesiones similares.
According to different authors, solitary plasmacytomas merely constitute a stage in the development of multiple myeloma, whereas other investigators state that these lesions are well-defined entities that respond favorably to surgery followed by radiation therapy and carry a much better prognosis than disseminated myelomas. We present the case of a 44 year-old man with a chief complaint of headaches and tonic-clonic seizures present for two months prior to admission. Neuroimaging studies revealed a right parietal tumor attached to the duramater suggesting meningioma. The lesion was surgically removed and it was diagnosed as solitary plasmacytoma following laboratory tests that ruled out systemic plasma cell dyscrasia. The patient has remained tumor-free for 4,5 years after surgery.
The medical literatu re concerning similar lesions is reviewed.
Bilateral Optic Nerve Compression as a Mechanism for the Foster Kennedy Syndrome
1989, Ophthalmology
An 11-year-old boy with a juvenile nasopharyngeal angiofibroma developed optic disc pallor in one eye and optic disc edema in the other eye (Foster Kennedy Syndrome [FKS]). The mechanism was believed to be bilateral, asymmetric optic nerve compression. Review of the 36 previously reported cases of FKS revealed that 12 cases (33%) were probably also caused by bilateral optic nerve compression. Only eight (22%) of the cases satisfied Foster Kennedy's original hypothesis for the pathogenesis of his syndrome, namely, direct compression of one optic nerve causing atrophy and increased intracranial pressure causing contralateral papilledema. In 15 (41%) reported cases of FKS, descriptions were inadequate to determine a mechanism, while two (5%) were probably caused by long-standing increased intracranial pressure without direct optic nerve compression. The authors believe that as sophisticated imaging permits earlier diagnosis and more precise localization, most future cases of FKS caused by mass lesions will be found to result from bilateral direct optic nerve compression.
Plasma cell dyscrasias: Current status
1988, Critical Reviews in Oncology and Hematology
Orbital Manifestations of Piasmacytic Lymphoproliferations
1987, Ophthalmology
Orbital involvement by plasmacytic lymphoproliferative disorders is rare. Presented are four cases, with different clinical onsets and courses, demonstrating the diversity of expression of lymphoproliferative plasma cell lesions of the orbit. The first patient presented with a slowly developing palpable mass in the upper and anterior orbit. This localized lesion proved to be a reactive plasma cell proliferation. The second case had a 3-month history of proptosis, diplopia, and droopy eyelid and a pulsatile temporal mass with bone destruction. Results of biopsy and systemic investigations showed a solitary plasmacytoma of bone. In the third case, a patient with a known multiple myeloma for 2 years presented with a progressive osteolytic mass which proved on biopsy to be a plasmacytoma. At the time, she also had other active bone lesions. The fourth case presented as a possible orbital cellulitis in a man with known multiple myeloma for 2 years. He proved to have disseminated myeloma, the orbital infiltrate being secondary to sinus involvement. The differential diagnosis for each case can be quite involved. Each case required a biopsy for an accurate diagnosis in addition to a complete clinical, radiographic, and laboratory workup. The pathologic features of each tumor can be misleading. These will be discussed as well as the use of ancillary diagnostic methods such as electron microscopy and immunohistochemistry to further characterize each lesion. The clinical course and treatment modalities will be discussed.
Classic Foster Kennedy Syndrome Triggered by Invasive Anaplastic Meningioma: Before and After
2023, Journal of Neuro-Ophthalmology
Intracranial tumor behavior of plasma cell neoplasms. Report of 2 cases and literature review
2013, Cirugia y Cirujanos

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Foster-Kennedy syndrome caused by solitary intracranial plasmacytoma

Am J Ophthalmol

Surg Neurol

Am J Ophthalmol

Surg Neurol

Am J Ophthalmol

Two cases of multiple myeloma (plasmacytoma) with secondary deposits in the dura mater

J Pathol Bacteriol

Intracranial solitary extraskeletal plasmacytoma resembling meningioma

Arch Neurol

Solitary myeloma: clinical and prognostic features of a review of 114 cases

Cancer

Notes on myeloma

Acta Radiol

Plasma cell myeloma. A clinical pathologic and roentgenologic review of 90 cases

Am J Clin Pathol

Case records of the Massachusetts General Hospital. Case 3-1973

N Engl J Med

Solitary plasmacytoma in the cranial cavity

J Neurosurg

A re-evaluation of solitary plasma cell myeloma of bone

Cancer

Cranial and intracranial myelomas

Brain

Solitary extramedullary plasmacytoma of the head and neck

Trans Am Acad Ophthalmol Otolaryngol

Extramedullary plasmacytoma

Am J Clin Pathol

Plasmacytoma of the hypothalamus

J Neuropathol Exp Neurol

Solitary dural plasmacytoma

Acta Pathol Microbiol Scand [A]

Intracranial solitary plasmacytoma (abstr)

Am J Clin Pathol

Papilledema: Its recognition and relation to increased intracranial pressure

Surv Ophthalmol

Plasma cell granuloma of the thyroid

Cancer

Solitary intracerebral plasmacytoma

Neurol Med Chir (Tokyo)