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Neuro-Myelomatosis of the Brachial Plexus – An Unusual Site of Disease Visualized by FDG-PET/CT: A Case Report

Hisanori Fukunaga, Tatsushi Mutoh, Yasuko Tatewaki, Hideo Shimomura, Tomoko Totsune, Chiaki Terao, Hidemitsu Miyazawa, Yasuyuki Taki

(Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University , Sendai, Japan)

Am J Case Rep 2017; 18:478-481

DOI: 10.12659/AJCR.903761

Published: 2017-05-01

BACKGROUND: Peripheral or cranial nerve root dysfunction secondary to invasion of the CNS in multiple myeloma is a rare clinical event that is frequently mistaken for other diagnoses. We describe the clinical utility of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/CT scanning for diagnosing neuro-myelomatosis.
CASE REPORT: A 63-year-old woman whose chief complaints were right shoulder and upper extremity pain underwent MRI and 18F-FDG PET/CT scan. MRI revealed a non-specific brachial plexus tumor. 18F-FDG PET/CT demonstrated intense FDG uptake in multiple intramedullary lesions and in the adjacent right brachial plexus, indicating extramedullary neural involvement associated with multiple myeloma, which was confirmed later by a bone marrow biopsy.
CONCLUSIONS: This is the first reported case of neuro-myelomatosis of the brachial plexus. It highlights the utility of the 18F-FDG PET/CT scan as a valuable diagnostic modality.

Keywords: Brachial Plexus Neuropathies, Central Nervous System, Fluorodeoxyglucose F18, Multiple Myeloma, Neoplasm Invasiveness, Positron-Emission Tomography