Solitary plasmacytoma of the breast

Abstract

Plasma cell neoplasms consist of a range of disorders from Monoclonal Gammopathy of Undetermined Significance to Multiple Myeloma. Solitary plasmacytomas are a part of this. Most commonly occur in bone. Extramedullary solitary plasmacytomas are extremely rare. Here we report a case of solitary plasmacytoma of breast which is extremely rare. The incidence is of the order of 0.01%. A fifty-year old postmenopausal female came to our Opd with the chief complaint of lump in lower inner quadrant of left breast since thirty to forty days. History and physical examination revealed a 3*3 cm firm, non tender palpable lump in upper medial quadrant of left breast. The biopsy revealed to be plasmacytoma. The immunohistochemistry was positive for markers like A full workup was done to rule out lesions in bone and any other site which included Complete Blood Count, Renal function test Serum Calcium, Peripheral Smear, Urine and Serum protein electrophoresis, Bone marrow Biopsy and Bone Biopsy, Skeletal Survey, Whole body PET CT. All these findings confirmed the diagnosis of Extraosseous Solitary Plasmacytoma of Left Breast. The treatment offered was Curative Radiotherapy to Left breast using conformal technique (3DCRT) to a total dose of 40 Gy in 20 fractions (2 Gy/#). The patient was examined weekly for any skin reaction or any other side effect. Dose constraints to organs at risk were kept well within the prescribed limits. After completion of treatment the patient is kept on monthly follow up. Physical examination and routine blood investigations are a part of routine follow up. Solitary plasmacytomas being extremely rare and when occur in soft tissues usually involve the upper aerodigestive tract and oral cavity. Primary involvement of breast in case of solitary plasmacytoma is extremely rare.