Central Nervous System Infiltration by Multiple Myeloma: Two Case Reports of a Rare Clinical Presentation

Abstract

Introduction: We present two case reports of rare and aggressive presentation of multiple myeloma, one of the most common hematological malignancies. To our knowledge, there are very few case reports of meningeal invasion by multiple myeloma, denoting the importance of describing the clinical features and the complementary investigation necessary to develop a better approach to these patients. Cases presentation: In case 1, we present a 64 years old patient with vague symptoms of headache associated with exacerbated tendinous reflexes and previous diagnosis of multiple myeloma. In case 2, a 58 years old presents with auricular plenitude, headache and encephalopathy, and a medical antecedent of multiple myeloma. Both were diagnosed with different sites of multiple myeloma central nervous system invasion, case 1 with predominant meningeal infiltration and case 2 with intraparenchymal infiltration. Conclusion: Analyzing these cases, we conclude that besides the rarity of the meningeal accometiment in myeloma patients compared to other hematological disorders, the identification of clinical signals and symptoms suggestive of this invasion is necessary to provide better health care to these patients.