Endocrine Pathology

, 1:245 | Cite as

Multiple myeloma presenting as a sellar plasmacytoma and mimicking a pituitary tumor: Report of a case and a review of the literature

  • AI-Noor N. Dhanani
  • Juan M. Bilbao
  • Kalman Kovacs
Case Report


A case of multiple myeloma presenting as a plasmacytoma and mimicking a pituitary tumor is reported. The importance of recognizing the existence of plasmacytoma in the differential diagnosis of sellar and parasellar tumors is stressed, as it leads to important differences in management. The literature is reviewed. Patients presenting with plasmacytoma with symptoms of a pituitary adenoma have an average age of 58 years; the male to female ratio is 3:1; diplopia, headache, and progressive visual loss are the most important symptoms; third, sixth, and fourth cranial nerve palsies are the most common signs; and pituitary function is usually normal. CT scan of the sellar region is the imaging modality of choice; pathologically, light and electron microscopy are invaluable in making the correct diagnosis. Making the correct diagnosis allows further appropriate investigation for systemic disease and consequent management.


Multiple Myeloma Pituitary Adenoma Pituitary Tumor Cranial Nerve Palsy Pituitary Function 


  1. 1.
    Ariel-Sanchez J, Rahman S, Strauss RA, Kaye GI. Multiple myeloma masquerading as a pituitary tumor (letter). Arch Pathol Lab Med 101:55–56, 1977.Google Scholar
  2. 2.
    Bayrd ED, Heck FJ. Multiple Myeloma—A Review of Eighty-Three Proved Cases. J Amer Med Assoc. 133:147, 1947.Google Scholar
  3. 3.
    Bitterman P, Ariza A, Black RA, Allen WE, Lee SH. Multiple myeloma mimicking pituitary adenoma. Comput Radiol 10:201–205, 1986.PubMedCrossRefGoogle Scholar
  4. 4.
    Calvo A, Purriel JA, Bastarricci E, Haberbeck MA. Tumors of the sellar region and the cavernous sinus. Evaluation of diagnostic procedures and treatment orientation. Acta Neurol Latinoam 26 (2): 111–122, 1980.PubMedGoogle Scholar
  5. 5.
    Clarke E. Cranial and intracranial myelomas. Brain 77:61–82, 1954.PubMedCrossRefGoogle Scholar
  6. 6.
    Cushing H. Intracranial Tumors; Notes upon a series of two thousand verified cases and the surgical-mortality percentages pertaining thereto. Springfield, IL: Thomas, 1932.Google Scholar
  7. 7.
    Estropinan V, Riogo P, Fernandez G, Varela C. Intrasellar plasmacytoma stimulating a pituitary adenoma (letter). Med Clin (Barc) 89:128, 1987.Google Scholar
  8. 8.
    Evans PJ, Jones MK, Hall R, Scanlon MF. Pituitary function with a solitary intrasellar plasmacytoma. Postgrad Med J 61:513–514, 1985.PubMedGoogle Scholar
  9. 9.
    Harrison LB, Schnall S, Cardinale FS, Farler LR. Multiple myeloma presenting as a pituitary tumor. Int J Radiat Oncol Biol Phys 13:653–654, 1987.PubMedGoogle Scholar
  10. 10.
    Honedo J, Calvo F, Aramburu P, Aragon G, de la Torre A, Arellano A, Otero J. Extramedullary IgDA plasmacytoma mimicking a pituitary chromophobe adenoma. Med Clin (Barc) 79:377–379, 1982.Google Scholar
  11. 11.
    Kerty E, Nakstad PH. Plasmacytoma masquerading as a pituitary tumor. J Neurol Neurosurg Psychiatry 47:99–100, 1984.PubMedCrossRefGoogle Scholar
  12. 12.
    Poon MC, Prchal JT, Murad TM, Galbraith JG. Multiple myeloma masquerading as chromophobe adenoma. Cancer 43:1513–1516, 1979.PubMedCrossRefGoogle Scholar
  13. 13.
    Silverstein A, Doniger DF. Neurological complications of myelomatosis. Arch Neurol. 9:102–112, 1963.Google Scholar
  14. 14.
    Urbanski SJ, Bilbao JM, Horvath E, Kovacs K, So W, Ward JV. Intrasellar solitary plasmacytoma terminating in multiple myeloma: a report of a case including electron microscopy study. Surg Neurol 14:233–263, 1980.PubMedGoogle Scholar
  15. 15.
    Vallat M, Vallat JM, Loubet A, Robin A. Plasmacytoma with pituitary localization. Report of a case. Bull Soc Ophtalmol Fr 81:355–356, 1981.PubMedGoogle Scholar
  16. 16.
    Vaquero J, Areitio E, Martinez R. Intracranial parasellar plasmacytoma (letter). Arch Neurol 39:738, 1982.PubMedGoogle Scholar

Copyright information

© Humana Press Inc. 1990

Authors and Affiliations

  • AI-Noor N. Dhanani
    • 1
  • Juan M. Bilbao
    • 1
  • Kalman Kovacs
    • 1
  1. 1.Department of Pathology, St. Michael’s HospitalUniversit of TorontoTorontoCanada

Personalised recommendations