{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:23:16Z","timestamp":1782739396522,"version":"3.54.5"},"reference-count":3,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>The \u201cRaindrop skull\u201d appearance represents the multiple punched-out and lytic lesions hitting a surface and creating a scattered splash pattern.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 73-year-old female presented with multiple painless lumps over the forehead and head. The patient reported unintentional weight loss, fatigability, loss of appetite, fever, night sweats, and back pain for seven months (B symptoms). The examination revealed multiple, nonmobile, calvarial lesions with defined borders, measuring approximately 1 \u00d7 1 cm. Laboratory investigations of serum-free light chains showed a free kappa level of 12.91 mg\/L, a lambda level of 4549.28 mg\/L, and a free kappa\/lambda ratio of 0.00. Radiological imaging of the skull and brain showed a \u201craindrop skull\u201d appearance and multiple calvarial osteolytic lesions. The patient underwent a right superior iliac crest bone marrow aspirate and trephine biopsy. The laboratory and histopathological sections were compatible with multiple myeloma. A diagnosis of multiple myeloma (free light chain lambda) was rendered.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Calvarial multiple myeloma is rare and requires a high index of suspicion to diagnose. \u201cRaindrop skull\u201d appearance is pathognomonic of calvarial multiple myeloma.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_874_2023","type":"journal-article","created":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T09:38:21Z","timestamp":1707471501000},"page":"34","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Calvarial multiple myeloma: Raindrop skull"],"prefix":"10.25259","volume":"15","author":[{"given":"Ali","family":"Alkhaibary","sequence":"first","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia."},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia."},{"name":"Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahoud","family":"Alharbi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia."},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia."},{"name":"Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Khairy","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia."},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia."},{"name":"Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2024,2,9]]},"reference":[{"key":"10.25259\/SNI_874_2023\/ref-1","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1007\/s13244-018-0643-0","article-title":"Radiological review of skull lesions","volume":"9","author":"Gomez","year":"2018","journal-title":"Insights Imaging"},{"key":"10.25259\/SNI_874_2023\/ref-2","first-page":"314","article-title":"Giant cranial plasmacytoma: Case report and discussion of a potential relationship with sex hormones","volume":"57","author":"Simsek","year":"2023","journal-title":"Neurol Neurochir Pol"},{"key":"10.25259\/SNI_874_2023\/ref-3","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1056\/NEJMicm1714471","article-title":"Raindrop skull","volume":"378","author":"Solis","year":"2018","journal-title":"N Engl J Med"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/calvarial-multiple-myeloma-raindrop-skull\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/calvarial-multiple-myeloma-raindrop-skull\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T09:38:24Z","timestamp":1707471504000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/calvarial-multiple-myeloma-raindrop-skull\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,9]]},"references-count":3,"alternative-id":["10.25259\/SNI_874_2023"],"URL":"https:\/\/doi.org\/10.25259\/sni_874_2023","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2024,2,9]]},"article-number":"34"}}