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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
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.