Intracranial Multifocal Dural Involvement in Multiple Myeloma: Case Report and Review of the Literature

Multiple myeloma is an incurable clonal B-cell malignancy with terminally differentiated plasma cells that accounts for 1% of all malignancies in the United States. It may present with tumors consisting of discrete masses of neoplastic monoclonal plasma cells in either bone or soft tissues. Central nervous system (CNS) involvement of myeloma is uncommon and is observed in approximately 1% of cases. It may manifest as dural myeloma or intraparenchymal infiltration, or with diffuse leptomeningeal involvement. Dural involvement of myeloma without parenchymal or leptomeningeal disease is an even rarer occurrence, with only 5 cases reported in the medical literature. There are no established treatment guidelines for CNS myelomatosis; prognosis and literature on the use of treatment modalities for this complication is reviewed herein.