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      Acúfeno como síntoma inicial de plasmocitoma de hueso temporal Translated title: Tinnitus as the initial symptom of temporal bone plasmacytoma

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          Abstract

          Resumen Los tumores de base de cráneo son inusuales, entre ellos el plasmocitoma surge de las células plasmáticas y puede ser el precursor del mieloma múltiple. Existen 2 tipos de plasmocitoma: el óseo solitario y el extramedular. Además, el plasmocitoma temporal es aún menos frecuente. El acúfeno puede ser la presentación inicial de estos tumores inusuales. Se presenta caso de una paciente femenina de 74 años, que inicia con acúfeno derecho, así como hipoa-cusia derecha. Acompañado de dolor cervical y limitación de la flexión cervical e inestabilidad. Como único dato a la otoscopia derecha presenta hipervascularidad del promontorio. Se realizan estudios de imagen reportando tumor con erosión ósea de ambas porciones petrosas de hueso temporal, esfenoides y columna cervical. Se realizó una biopsia transesfenoidal reportando plasmocitoma CD 138 positivo. Se inició quimioterapia y radioterapia. El acúfeno unilateral debe estudiarse ampliamente ya que puede ser síntoma de diagnósticos inusuales como neoplasias de base de cráneo.

          Translated abstract

          Abstract Skull-base tumors are unusual, Plasmacytoma arises from plasma cells and could be the precursor of multiple myeloma. There are 2 types of plasmacytoma: solitary bone and extramedullary. Temporal bone plasmacytoma is even more infrequent. Tinnitus could be the initial symptom of this unusual tumors. We present the case of a 74-year-old female patient, who started with right tinnitus as well as right hearing loss. Accompanied by cervical pain and limitation of cervical flexion and instability. As the only data on right otoscopy, there was an hypervascular promontory. Imaging studies were performed reporting tumor with bone erosion of both petrous portions of temporal bone, sphenoid, and cervical spine. A transsphenoidal biopsy was performed, reporting positive CD 138 plasmacytoma. Chemotherapy and radiotherapy were indicated. Unilateral tinnitus should be fully studied because it might be a symptom of unusual diagnoses such as skull base neoplasms.

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          Most cited references15

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          Solitary clival plasmocytomas: Misleading clinical and radiological features of a rare pathology with a specific biological behaviour.

          Tumours of the clivus are exceptionally rare, representing a diagnostic and a therapeutic challenge. Clival solitary plasmocytomas have been described only as single case reports or included in small clinical series with other intracranial location.
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            Plasmacytoma of the Skull-base: A Rare Tumor

            Plasmacytoma of the skull-base is a rare entity. Differential diagnosis includes chordoma, osteosarcoma, carcinoma nasopharynx, meningioma, metastatic carcinoma, lymphoma, and multiple myeloma. Accurate and precise diagnosis is extremely important for plasmacytoma of the skull-base as its treatment and prognosis is different from other skull-base lesions. A 41-year-old man presented with concerns of headache, diplopia, and left eye strabismus. A magnetic resonance image (MRI) of his brain showed a large expansile mass measuring 51 mm involving the clivus and central skull-base. Trans-sphenoidal tumor decompression was done. A biopsy confirmed the plasmacytoma. A positron emission tomography-computed tomography (PET-CT) scan showed a single 2-(18F) fluoro-D-glucose (FDG) avid lesion at the skull-base. The results of all other relevant investigations such as hemoglobin, renal function test, serum calcium, serum protein immunoelectrophoresis, serum quantitative immunoglobulin, bone marrow biopsy, serum lactate dehydrogenase, and beta-2 microglobulin levels were within normal limits. He was treated with radical radiotherapy. He developed complete clinical response after radiotherapy.
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              Solitary nonchordomatous lesions of the clival bone: differential diagnosis and current therapeutic strategies.

              A nonchordomatous solitary lesion of the clival bone is an exceptionally rare pathological entity, which represents a diagnostic and a therapeutic challenge. Many diseases with extremely different biological behavior, and requiring a dedicated treatment strategy, may result in similar clinical patterns. The approach to a correct differential diagnosis has to consider the specific epidemiological, radiological, and histopathological characteristics of each pathology to minimize the diagnostic bias and to allow the planning of the best treatment strategy. Because of the rarity of these diseases, a systematical review of nonchordomatous lesions of the clival bone still lack in the literature. The purposes of this study are to provide an overview of the epidemiological, clinical, radiological, and histopathological characteristics of nonchordomatous clival lesions, with particular emphasis on diagnostic and therapeutic strategies and related clinical outcome.
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                Author and article information

                Journal
                orl
                Revista de otorrinolaringología y cirugía de cabeza y cuello
                Rev. Otorrinolaringol. Cir. Cabeza Cuello
                Sociedad Chilena de Otorrinolaringología, Medicina y Cirugía de Cabeza y Cuello (Santiago, , Chile )
                0718-4816
                June 2021
                : 81
                : 2
                : 215-221
                Affiliations
                [1] Sinaloa orgnameUniversidad Autónoma de Sinaloa orgdiv1Centro de Investigación y Docencia en Ciencias de la Salud Mexico
                Article
                S0718-48162021000200215 S0718-4816(21)08100200215
                10.4067/s0718-48162021000200215
                b4ec476e-1cca-4b60-be0c-7f18a712722e

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 07 October 2020
                : 02 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 7
                Product

                SciELO Chile

                Categories
                CASOS CLÍNICOS

                radiotherapy,tinnitus,temporal bone,Plasmacytoma,radioterapia,acúfeno,hueso temporal,Plasmocitoma

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