Cerebral tumor with hemi-dural enhancement as unique presentation of multiple myeloma: A case report.

IntroductionIntracranial multiple myeloma (MM) is a rare manifestation of MM, a malignant plasma cell disorder that primarily affects bone marrow. Dural involvement in MM is even rarer and can manifest as a dural mass. We present a case of MM presenting as an intracranial dural tumor with primary hemi-dural involvement.Research questionThis case report aims to investigate the clinical presentation, diagnostic challenges, and treatment approaches for intracranial multiple myeloma, with a focus on the extensive hemi-dural thickening and enhancement seen in this case.Material and methodsA 73-year-old male presented with progressive dysphasia and weakness. MRI revealed a solid left frontal mass with significant mass-effect. Hemi-dural thickening and enhancement was present along with invasion of the skull. The patient underwent surgical resection of the tumor with dural and bone reconstruction.ResultsHistopathological examination confirmed MM diagnosis. Chemotherapy was started. Follow-up MRI showed complete tumor resection, but extensive hemi-dural thickening and enhancement persisted. Postoperative radiation therapy was considered.Discussion and conclusionMM with primary dural involvement is rare and poses diagnostic challenges. Postoperative treatment involves chemotherapy, the role of surgery and radiotherapy is not established. The extensive hemi-dural thickening and enhancement observed in this case require further investigation, and a wait-and-scan policy was recommended instead of radiotherapy.