Work

Suspected central nervous system involvement in multiple myeloma on MRI

Year: 2025

Type: article

Abstract: Central nervous system involvement in multiple myeloma (CNS-MM) is rare, typically appearing at relapse and associated with poor prognosis. We report the case of a 67-year-old woman with high-risk IgA lambda multiple myeloma who developed early relapse with extensive extramedullary disease and atypical brain MRI findings. Imaging revealed abnormal thickening and heterogeneous enhancement of the pituitary stalk as well as signs suggestive of cerebral venous sinus thrombosis (CVST), raising suspicion of CNS involvement. Cerebrospinal fluid analysis was not performed due to rapid clinical deterioration, leaving the diagnosis probable rather than confirmed. This case is notable for its unusual site of CNS manifestation and rapid progression despite multiple lines of therapy. It highlights the diagnostic uncertainty surrounding Central nervous system involvement in multiple myeloma (CNS-MM) and emphasizes the importance of integrating imaging and clinical data for timely recognition of this rare and aggressive complication.

Source: Radiology Case Reports

DOI: 10.1016/j.radcr.2025.11.084

Authors: Fabiana Andrade Melchiori, Mette Niemann Christoffersen, Konstantina Foufa

Institutions: Odense University Hospital, Kolding Hospital, Lillebaelt Hospital

Language: English

Topic: Multiple Myeloma Research and Treatments

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $600