• Wenzhen Yang, Jing Zheng, Ruihao Li, Haijun Ren, Boru Hou, Zhiyong Zhao, Dengfeng Wang, Gang Wang, Jixing Liu, Guizhong Yan, Dong Wang, and Xinding Zhang.
• Department of Neurosurgery, the 2nd Hospital of Lanzhou University.
• Medicine (Baltimore). 2018 Sep 1; 97 (39): e12327.

RationaleMM is a malignant tumor originating from the plasma cells of the bone marrow. Central nervous system myelomatosis is very rare and may be a complication of MM.Patient ConcernsA 60-year-old man presented with a slowly growing soft mass at his right frontal scalp after a mild head injury 6 months ago.DiagnosesNeuroradiological examinations revealed a solid intracranial-extracranial mass with an osteolytic lesion in the skull. Histopathological examination showed skull plasmacytoma, and postoperative examinations revealed multiple myeloma.InterventionsThe tumor was completely removed and the skull defect repaired with the titanium mesh. Then, chemotherapy was initiated after surgery with bortezomib and dexamethasone.OutcomesThe patient received eight chemotherapies within one year after surgery.LessonsDespite a history of head injury, a differential diagnosis should be kept in mind during the diagnosis of solid intracranial-extracranial masses, especially in the presence of osteolytic skull at the lesioned site.

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