Case contributed by A.Prof Frank Gaillard

A large destructive enhancing mass arises from the left side of the occipital bone and mastoid extending into the posterior fossa.

The patient went on to have a biopsy. 


Microscopic Description: 

The biopsy of retroauricular mass shows skeletal muscle which is heavily infiltrated by plasma cells. While many of these are almost normal appearing, there are several extremely atypical cells with enlarged nuclei, prominent nucleoli and an increased nuclear-to-cytoplasmic ratio. The biopsy is crushed and little material was left on the immunoperoxidase slides, but these appear to show that the lesion stains for IgG kappa.

Final Diagnosis: plasmacytoma.

The patient went on to receive radiotherapy. 


Post radiotherapy (6months)

Radiotherapy resulted in marked reduction in the size of the mass and resolution of mass effect upon the posterior fossa content. 

Case Discussion

The differential of masses appearing to arise from the skull includes primary bone tumors (e.g. osteosarcoma), metastases and multiple myeloma, as well as involvement by masses from within the intracranial cavity (e.g. meningioma and hemangiopericytoma) or from the scalp (e.g. squamous cell carcinoma). 

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Case information

rID: 4309
Published: 7th Aug 2008
Last edited: 13th Aug 2019
Inclusion in quiz mode: Included

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