Solitary Plasmacytoma: A Review Of Clinical, Ocular, Neurological And Other Systemic Manifestations

Abstract

Solitary plasmacytomas are defined as proliferation of monoclonal plasma cells without evidence of significant bone-marrow plasma-cell infiltration. They are classified according to location into solitary plasmacytoma of bone if they occur in bone, and extramedullary plasmacytoma if they arise in soft tissues. They are more frequent in males than females and have a peak incidence in the fifth and sixth decade of life. Solitary plasmacytoma accounts for about 5% of plasma cell tumours. More than 80% of extramedullary plasmacytoma occur in the upper aero-digestive tract or the head and neck region. Diagnosis is based on histologic confirmation of monoclonal plasma cell infiltration of a single disease site and on the exclusion of systemic myeloma. The development of multiple myeloma from solitary plasmacytoma occurs in approximately 60% of patients within 10 years of diagnosis. Prognosis is good and cure can be attained in extramedullary plasmacytoma. Therapeutic options include radiotherapy, chemotherapy and surgical excision. The aetiology of plasmacytoma is still unknown. Extramedullary plasmacytoma can affect practically all the systems in the body including the eyes, nervous system, head and neck, respiratory system, breast, gastrointestinal system, urogenital system and lymph nodes. These systemic manifestations are reviewed. Key words: Plasmacytoma, ocular, outcome, neurological, prognostic factors