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01 May 2017 : Case report  Japan

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

Mistake in diagnosis, Unusual setting of medical care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Hisanori Fukunaga12DEF, Tatsushi Mutoh1DE*, Yasuko Tatewaki1DE, Hideo Shimomura1D, Tomoko Totsune1D, Chiaki Terao1D, Hidemitsu Miyazawa3D, Yasuyuki Taki1DE

DOI: 10.12659/AJCR.903761

Am J Case Rep 2017; 18:478-481

Abstract

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, Positron-Emission Tomography

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923