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Diffuse Infiltration of Multiple Myeloma With Initial Manifestation of Cavernous Sinus Syndrome Unveiled by 18F-FDG PET/CT

Li, Chunyan MD*,†; Shao, Fuqiang MD*,†; Yang, Yuhui MD; Lan, Xiaoli MD, PhD*,†

doi: 10.1097/RLU.0000000000002722
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Intracranial infiltration is a rare complication of multiple myeloma (MM), which is usually seen in advanced stage. Here, we report a 47-year-old woman with only cavernous sinus syndrome as first manifestation. Brain MR revealed cavernous sinus masses, leptomeningeal nodules, and osseous erosion, which were considered metastases. 18F-FDG PET/CT, which was further performed to identify potential primary lesions, showed increased uptake not only in cavernous sinus and leptomeninges but also in diffuse bone lesions, hepatic nodules, lymph nodes, subcutaneous nodules, and bilateral ovarian masses. Multiple myeloma with intracranial involvement was confirmed by biopsy and cerebrospinal fluid examination.

From the *Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Hubei Province Key Laboratory of Molecular Imaging

Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Received for publication February 16, 2019; revision accepted June 1, 2019.

Conflicts of interest and sources of funding: This work was supported by the National Natural Science Foundation of China (No. 81801760), and Hubei Technical Innovation Major Project (No. 2017ACA182). The authors declare no conflicts of interest.

Correspondence to: Xiaoli Lan, MD, PhD, 1277 Jiefang Ave, Wuhan 430022, Hubei, PR China. E-mail:

Online date: July 15, 2019

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