Case Of Solitary Plasmacytoma Research Articles

Diagnostic Role of Serum Protein Electrophoresis

Introduction: Electrophoresis is a technique for separation of different charged particles. It is based on movementof charged particles through a solution when subjected to an electrical field. Since proteins are negatively chargedat pH 8.6, subjecting them to electrical field will push protein particles towards anode.Materials and Methods: Place of Study: This study was carried out in the Department of Pathology,RampurhatGovernment Medical College & Hospital, Birbhum, West Bengal, India.Period of Study: Study was conducted from January 2020 to March 2022.Study Design: ProspectiveAge Group: 1st decade to 8th decadeControl Group: 10 male and 10 female healthy persons of every decade were chosen as control groups.Result: Cellulose acetate electrophoresis of 150 symptomatic patients performed. Major diseases diagnosed wereMultiple Myeloma(24 cases), Chronic inflammatory disease (15 cases),HIV (13cases), Hematological malignancy(10cases), solid malignancy (10 cases), tuberculosis (7 cases) with some Miscellaneous conditions.Among the 28 Monoclonal Gammopathy cases studied(100%),the most common case was Multiple Myeloma(24 cases, 85.71%) followed by 2 cases of Solitary Plasmacytoma(7.15%) and 1 case of Monoclonal Gammopathy ofundetermined significance( MGUS) (3.57%) and 1 case of Smoldering Myeloma (3.57%).

Plasmocitoma/multiple myeloma with severe cord compression: Case reports

Abstract Introduction: Multiple myeloma (MM) is generally located in the bone marrow (BM) and is associated with a wide spectrum of clinical, laboratory, and radiological findings.[1] Conversely, solitary plasmacytoma (SP) is characterized by a single mass of clonal plasma cells, with no or minimal BM plasmacytosis and with no other symptoms than those derived from the primary lesion.[2] The cases with spine involvement and spine cord suffering from compression always were very complicated and challenging. Materials and Methods: We describe two cases of SP and MM with severe spine cord compression treated surgically with an indication to address the compression and stabilization of the affected segments with subsequent treatment in hematology and oncology. Results: In both cases, the surgery was a success, the patient with SP survived 3 years and 1 month, and the patient with MM survived 1 year and 3 months. Conclusion: The outcomes of surgical interventions for these patients with spine cord compression and spinal instability due to MM and plasmacytoma of the spine were improved with neurological function following surgery and no instrumentation failure.

Improvements in myeloma specific survival over the last two decades.

e18503 Background: Improvement in overall survival (OS) have been observed among myeloma patients over the last several decades, mainly due to improvement in therapeutic options. For a disease, more common in the elderly (median age of diagnosis of 70), and a median reported OS exceeding 10 years (Joseph et al JCO 2020), reaching normal life-expectancy for a myeloma patient has become more realistic now than ever before. In this context, where the competing risks for mortality for myeloma patients are higher, we have evaluated the changes in the myeloma specific survival (MSS) using a population-based database Surveillance, Epidemiology, and End Results (SEER)-18 database. Methods: Interrogation for International Classification of Diseases (ICD) for Oncology 3rd edition histology codes 9731/3 resulted in 65848 cases. After excluding 1360 cases of extraosseous plasmacytoma and 2011 cases of solitary plasmacytoma of bone, a total of 62477 cases of myeloma were found. 9322 cases were excluded due to myeloma not being the primary malignancy, leaving a total of 53155 cases with active follow for the primary analysis. OS and MSS were estimated using the Kaplan-Meier method. Improvements in OS and MSS were compared by 4 eras (1975-88; 1989-1998; 1999-2008; 2009-2018) by race and gender. Results: White patients (40040 -75.3%) and males (28104 -52.9%) comprised majority of the study population. 9495 black patients (17.9%) and 3004 Asian/Pacific Islanders (5.7%) were the other major racial groups included in the analysis. The median OS for myeloma patients in the era 1975-1988 was 24 months (95% CI 23.22-24.77) while the simultaneous median MSS was 32 months (95% CI 31-32.99). Significant improvements in OS occurred by the era of 2008-2018 (56 months (95% CI 54.31-57.69). Improvement in MSS was more prominently observed during this era - 87 months (95% CI 83.2-90.80). The OS and MSS for each of the groups by gender and race have been tabulated in table. Conclusions: OS and MSS have improved over the last two decades, more prominently in the last decade. Improvement in MSS clearly highlights the fact that myeloma as the primary cause of death has declined over the last two decades among most groups of patients and it is encouraging to see the benefit extending to the minorities. Future studies may incorporate MSS as an endpoint, which might accurately reflect the benefit offered by the newer safer therapeutics.

Solitary plasmacytoma in the maxillary sinus: 10-year follow-up.

Solitary plasmacytoma (SP) is an uncommon form of plasma cell neoplasm occurring intraosseously or in soft tissue and presents as a single mass of monoclonal plasma cells. SP in the maxillary sinus is rare and can be misdiagnosed as other maxillary sinus tumors. The essential examinations in patients with the initial diagnosis of plasmacytoma are bone marrow biopsy, serum and urine electrophoresis, and kappa/lambda ratio (κ:λ ratio) to rule out multiple myeloma (MM). Herein, a rare case of SP in the maxillary sinus treated by surgery and localized radiation is reported. At the 10-year follow-up examination, local recurrence or disseminated development of MM were not evident.

Solitary Plasmacytoma of The Sternal Stalk: A Case Report and Literature Review

Background: It has been reported that sternal neoplasms are a rare disease, accounting for about 1% of primary bone neoplasms, of which about 60% are malignancy, mostly occurring in the manubrium sternum. Case presentation: We reviewed a 77-year-old man with a solitary plasmacytoma of the sternal stalk presenting with pain in the anterior chest wall by examining a preoperative diagnosis of sternal manubrium malignant bone tumor. We performed extensive sternal manubrium tumor resection + bilateral partial costal cartilage resection + bilateral clavicular head resection + cervical lymph node dissection + thoracic reconstruction, and the postoperative recovery was perfect. Conclusion: We report a rare case of solitary plasmacytoma of the manubrium sternum successfully treated by extensive radical surgery for the manubrium tumor. Although rare, the disease should be identified, examined, and treated early to avoid serious complications.

A case of solitary plasmacytoma of bone showing co-expression of both immunoglobulin light chains

BackgroundSolitary plasmacytoma of bone (SPB) is a rare plasma cell neoplasm. It arises in bone as a single locus in the absence of any plasma cell myeloma lesions. Plasma cell neoplasms intrinsically express only one immunoglobulin light chain (IgL)—kappa or lambda—and using this fact, kappa/lambda deviation is the decisive factor for diagnosis. Co-expression of both IgLs in a single tumor cell is extremely rare.Case presentationWe report a case of SPB that arose in the vertebra of a 52-year-old Japanese woman. Histologically, the resected mass showed diffuse plasma cell proliferation. Dual IgL expression was detected by flow cytometry, immunohistochemistry, and in situ hybridization (ISH) targeting IgL mRNA.ConclusionWe have presented an extremely rare case of SPB showing dual expression of kappa and lambda IgLs. This unusual case of plasma cell neoplasia might represent a possible exceptional example of failure of “IgL isotypic exclusion.”

Plasmacytoma of the mandible: A diagnostic conundrum

Plasma cell dyscrasias are neoplastic proliferation of monoclonal plasma cells that encompass a wide range of entities. Plasmacytoma may present as one of two distinct clinical entities: Multiple myeloma and solitary plasmacytoma. The incidence of solitary plasmacytoma is 2-5% among all plasma cell neoplasms and it commonly involves long bones and vertebrae. Its occurrence in the jaw is extremely rare and only 4.4% are seen in mandible. Clinically, plasmacytoma of mandible presents as pain, tooth migration, hard and soft tissue swelling or pathological fracture. Radiologically, it presents as unilocular or multilocular lesion mimicking odontogenic tumour creating a diagnostic dilemma.We report a series of 3 cases of plasmacytoma of the mandible with comprehensive details of clinico-radiological, histological, immunohistochemistry findings and treatment with a review of the literature.These three cases were clinically mistaken for Ameloblastoma, Odontogenic tumour and Oral cancer respectively. There was one case of Solitary Plasmacytoma and two cases on further workup proved to be multiple myeloma. All these cases were confirmed by immunohistochemistry.Plasmacytoma of mandible is very rare. It is usually mistaken for other common mandibular lesions and oral cancers. Every attempt must be made to diagnose them precisely as management is quite specific. To best of our knowledge, this is the first series of plasmacytoma of the mandible in the Indian literature.

A case of solitary plasmacytoma in the mandible

A case of solitary plasmacytoma in the mandible

Nasal Plasmacytomas: Report of Two Cases and Revision of the Literature

Solitary plasmacytomas (SP) represent less than 1% of head and neck (HN) tumors. The most frequent initial presentation in HN of SP is at the naso-sinusal and nasopharynx levels (75%). The article present two cases of naso-sinusal SP treated at our Center recently with endoscopic surgery followed by radiation therapy, focusing in the combined modality treatment for this disease.

PB2119 CLINICAL PRESENTATION AND OUTCOMES OF SOLITARY PLASMACYTOMA IN A LARGE TERTIARY HOSPITAL: A RETROSPECTIVE COHORT STUDY

Background:Solitary plasmacytoma is a rare neoplasm of monoclonal plasma cells presenting as either Solitary Bone Plasmacytoma (SBP) or Solitary Extramedullary Plasmacytoma (SEP), without evidence of systemic disease. Standard treatment typically involves radical radiotherapy resulting in prolonged remissions in the majority of cases. However, previous studies have identified a high‐risk group of patients with an increased risk of progression to multiple myeloma. Due to the rarity of this plasma cell dyscrasia, there are few published clinical trials.Aims:To identify risk factors for progression to myeloma, evaluate survival outcomes and determine the incidence of secondary malignancies in a cohort of solitary plasmacytoma patients.MethodsWe retrospectively reviewed case records of adult patients with plasmacytoma treated in a 15‐year period (2002‐2017) at Addenbrookes Hospital, the regional tertiary hospital for the Eastern region of England. Patients with multiple plasmacytomas or meeting the criteria for multiple myeloma at the time of diagnosis were excluded. Clinical, laboratory and radiological features at diagnosis and during the course of treatment were analyzed. Time to progression to myeloma were recorded and survival outcomes analyzed using the Kaplan‐Meier method. The data cut off date was the 1st of July 2018.Results:Thirty‐three (33) cases of solitary plasmacytoma were identified (Table 1): 26 (79%) SBP and 7 (21%) SEP. The mean age at diagnosis was 63 years with a 2:1 male preponderance. The thoracic vertebrae were the commonest sites for SBP while SEP occurred most frequently in skin and soft tissue. Pain and spinal cord compression were the most frequent presenting symptoms. A paraprotein was detectable in 19 (58%) patients at the time of diagnosis, predominantly IgG (68%). The majority of patients received radiotherapy alone (79%) while two patients received wide local excision as the sole modality of treatment. The median total dose of radiation received was 50 gray in 25 fractions (range: 40Gy‐65 Gy). Over a median follow up of 48 months, 13 patients (39%) progressed to multiple myeloma. Median time of progression to myeloma was 22 months but notably, two patients progressed more than 5 years after radiotherapy. There was a trend towards progression for patients with non‐IgG paraprotein and paraproteinemia >10 g/l (relative risk 2.2, 95% CI 0.8‐5.8). From pooled analysis of overall survival, 5‐and 10‐year survival rates were 80% and 57% respectively (Figure 1). The median progression‐free survival was 85 months (Figure 2). Following progression to myeloma, the median survival was 48 months. Over the course of follow up, 5 patients (15%) developed a second malignancy with lung cancer being the most frequent.Summary/Conclusion:Solitary plasmacytoma generally has a good prognosis but progression to multiple myeloma predicts inferior survival. Previous studies have suggested a number of predictive factors for progression but these have not been validated in large prospective studies. In this retrospective cohort, the presence of a significant (>10 g/l) paraprotein and non‐IgG type appeared to increase the likelihood of progression to myeloma but this observation was limited by the relatively small sample size. In the era of novel therapies for myeloma, there is a need for clinical trials investigating adjuvant therapies for high risk solitary plasmacytoma. We also suggest long‐term monitoring of solitary plasmacytoma patients due to the finding of late progression (>5 years) and the incidence of secondary cancers in this study.image

A case of solitary plasmacytoma in the mandible transformed into multiple myeloma

A case of solitary plasmacytoma in the mandible transformed into multiple myeloma

Multi-Disciplinary Approach for Managing Plasmacytoma: A Case Report

Solitary plasmacytoma (SP) is a tumor with evidence of clonal plasma cells and no other features of multiple myeloma (MM). We report a case of SP which showed multiple recurrences of SP and then evolution into overt MM. A 56-year-old man presented with the 5-month-history of right nasal obstruction and intermittent epistaxis. He had SP (extraosseous) of right nasopharynx (3.5 × 2 × 2.5 cm), with no paraproteinaemia. He received radiotherapy (56 Gy), achieving complete remission. Ten years later, he had recurrence of SP (osseous) in left tibia, presenting with pathological fracture. He received radiotherapy (50 Gy), achieving partial response. Three years later, he had recurrence of SP (osseous) in right tibia, presenting with right leg pain. He received radiotherapy (45 Gy). While receiving treatment, he had progressive swelling in the area around right eye, double vision and headache. Imaging scans showed multiple plasmacytomas. There were presence of monoclonal paraprotein, hypercalcemia and lytic bone lesions. He was diagnosed as MM (at the age of 70 years) and treated with Bortezomib-based therapy. Currently, after one cycle of treatment, clinical improvement is achieved. The importance of multi-disciplinary team approach for managing patients with plasmacytoma is highlighted in order to achieve the holistic approach of management.

99Tcm-MDP imaging on a case of solitary plasmacytoma of bone

99Tcm-MDP imaging on a case of solitary plasmacytoma of bone

下顎骨に生じた骨の孤立性形質細胞腫の1例

下顎骨に生じた骨の孤立性形質細胞腫の1例

Imaging Features of Solitary Plasmacytoma of Bones

Objective To improve diagnostic ability by analyzing the imaging features of X-ray,CT and MRI for solitary plasmacytoma occurred in different sites of bones.Methods We retrospectively reviewed twelve pathologically proven cases of solitary plasmacytoma that existed on centrums,shoulder bones and ribs,and summarized their imaging features.Results The prevalence bones were the rib(n=3),thoracic vertebra(n=6),and the shoulder bone(n=3).Of those,pathological fracture had one case on shoulder bone.X-ray and CT showed osteolytic destruction and expansive growth with relative clear border.Periosteal reaction was not observed in all cases,although one case had cortical bone thickening,hardening.Solitary plasmacytoma showed homogeneous slight hypo-intensity on T1-weighted MR images and hyper-intensity on T2-weighted MR images compared to muscle.Peritumoral edema was not observed in all the cases,but soft-tissue invasion in various degree was clear and soft-tissue mass was apparent in five cases with enhanced contrast.Conclusion X-ray was lower sensitive for solitary plasmacytoma in bones;CT could clearly show the thickening trabecula and residual bone in the tumor;MRI could show the relationship between exterior and interior pathological of medullary cavity and surrounding soft tissue.Combination of radiography,CT and MR imaging might improve diagnosis.

Solitary plasmacytoma of clavicle: A case report

Introduction: Plasmacytoma is a localized collection of malignant plasma cells. The disease can be divided into solitary plasmacytoma of the bone (SPB) and extramedullary plasmacytoma (EMP), both of which are distinct entities. An EMP, the rarer of the two, has soft tissue infiltration by clonal plasma cells without any occult or systemic myeloma. Whereas, SPB has a solitary lytic bone lesion with infiltration of monoclonal plasma cells, with absence of the same on a random marrow sampling or any evidence of systemic myeloma. Though SPB may involve any bone in the body but involvement of medial end of clavicle, though reported, is extremely rare. Case Report: Herein, we report a case of a 65­year­old farmer presented with pain and swelling of the medial end of the left clavicle, which was postoperatively diagnosed to be a solitary plasmacytoma by virtue of histopathology and IHC, with no other evidence of osteopenic lesions on radiographs, a negative bone scan, absence of marrow involvement by monoclonal plasma cells, presence of M­band on serum protien electrophoresis, in the IgG region and no evidence of anemia, hypercalcemia, hyperuricemia, hypercreatininemia, nephropathy, respiratory and urinary tract infections that can suggest the presence of any systemic myeloma. Conclusion: The case of solitary plasmacytoma of the clavicle reported here is a very rare as a disease entity, and rarest because of the site of involvement. The patient was treated with surgery and radiotherapy and had excellent disease control.

A resected case of solitary plasmacytoma of the rib

症例は57歳男性．健診で胸部異常陰影を指摘された．胸部CTにて右第5肋骨後方に骨皮質を外側へ圧排する55×18 mmの腫瘤を認め，骨シンチでは99mTc-HMDPの異常集積を認めなかったが，PET-CTではSUV max 58.0の18F-FDG集積がみられた．他部位には異常集積は認めなかった．肋骨悪性腫瘍の可能性を否定できず，右第5肋骨切除術を施行した．病理組織学的に形質細胞腫との診断であった．多発性骨髄腫を否定するために術後腸骨より骨髄穿刺を施行するも異常所見は認めず，最終的に肋骨原発の孤立性形質細胞腫と診断された．追加治療は施行せず，術後32ヵ月経過した現在，無再発生存中である．肋骨に原発した孤立性形質細胞腫は稀な疾患であり，報告する．

Solitary Plasmacytoma of the Jaw

There is a lack of consensus on the appropriate management of solitary plasmacytoma (SP) of the jaw. The aim of the present investigation was to provide scientific evidence for the optimal management of this disease through a systematic literature review. The included articles are published in English from 1948 to March 2011 and describe the population affected by SP of the jaw with site, clinical and radiographic features, special findings, initial diagnosis, treatment, and follow-up. Fifty cases of SP of the jaw were identified. It typically presents as a single osteolytic lesion with no plasmocytosis involvement of bone marrow. Long bones and vertebrae are the most common sites of SP. Rarely, it involves the jaw occurring in only 4% of cases, mainly in the bone marrow-rich areas, angulus and ramus. Solitary plasmacytoma of the jaw has a worse prognosis than multiple myeloma (MM), and in half of the cases, it evolves in MM. Because SP of bones is an uncommon tumor that rarely involves the jaws, through this article we emphasize early diagnosis and appropriate management to avoid progression to MM.

Solitary plasmacytoma of the rib: A rare case

Localized solitary plasmacytoma of the bone is a rare disease and is characterized by only one or two isolated bone lesions with no evidence of disease dissemination. We report a case of solitary plasmacytoma of the rib in a 43-year-old female. The patient underwent complete en-bloc resection of the chest wall including rib, muscle, and parietal pleura. Patient is asymptomatic without any recurrence after two and half years of follow up.

Tomografía por emisión de positrones con 18F-fluorodeoxy-glucosa en un caso de plasmocitoma solitario de paladar blando

Solitary plasmacytoma is an uncommon tumor of plasma cells that can appear in the head and neck. It must be differentiated from multiple myeloma because of its initial presentation. A case of solitary plasmacytoma on the palate is presented. Furthermore, role of 18F-fluorodeoxyglucose Positron Emission Tomography ( 18F-FDG-PET) in its initial staging is analyzed.