Solitary Plasmacytoma Of Bone Research Articles

Decrease of CD38 expression is linked to increase of solitary plasmacytoma pathological grade: a single institution experience from China.

Solitary plasmacytoma (SP) is a rare plasma cell disorder characterized by localized neoplastic proliferation of monoclonal plasma cell. Due to its rarity, further understanding of the spectrum of its clinicopathologic features is needed. A retrospective analysis of cases from a single institution was conducted. Clinical characteristics of the patients were collected; histopathological and semi-quantitative immunohistochemical analyses were performed. Thirteen cases were identified from our pathology archives, including 4 cases of solitary plasmacytoma of bone (SPB) (30.8%) and 9 extraosseous plasmacytoma (EP) (69.2%). The mean age of EP is a decade older than SPB. There is no gender disparity. The most common sites involved are the vertebrae and nasopharynx. Histologically, the tumors can be classified into two grades based on degree of differentiation. Immunohistochemically the tumor cells express CD38, CD138, MUM-1, and exhibit light chain restriction. Ki-67 proliferation index is 30%. In situ hybridization for Epstein-Barr virus-encoded small RNAs (EBER) is negative in six cases tested. Semi-quantitative immunohistochemical analysis showed decreased integrated optical density (IOD) of CD38 in neoplastic cells. IgH gene rearrangement was identified in two cases. SP is a rare plasmacytoid neoplasm that occurs more frequently in older patients. Diagnosis requires a systematic clinical approach combined with the pathological characteristics of plasmacytoid morphology, immunophenotype and light chain restriction. There are more cases of EP than SPB in our series, which is in contrast to that reported in literature. Results from this study suggest that CD38 is a potential immunohistochemical marker associated with prognosis of SP. Further studies with more cases and longer term follow-up may provide more definitive information on risk of progression from SP to multiple myeloma (MM).

A Case Report: Solitary Plasmacytoma of bone (SPB) Presenting as an Incidentaloma in a COVID-19 Positive Patient

A 70-yr-old covid positive male patient who presented with cough and shortness of breath, upon CT chest found to have features typical of COVID-19 infection and a small mass arising in left 8th rib. A histopathological examination of the mass found to be osseous plasmacytoma, after a PET scan it was confirmed to be a solitary lesion. Bone marrow aspiration cytology showed normal plasma cell count, thus, diagnosed as solitary Plasmacytoma of bone. There was no negative impact on the recovery of the patient by COVID-19 due to solitary Plasmacytoma.

Casual finding of a solitary costal bone plasmacytoma in somatostatin receptor scintigraphy

Casual finding of a solitary costal bone plasmacytoma in somatostatin receptor scintigraphy

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.”

Exploring Solitary Bone Plasmacytoma: A Rare Case Report

The Solitary Bone Plasmacytoma (SBP) is a rare oncologic disease corresponding to less than 5% of the malignant neoplasms of the plasma cells. It is characterized as a localized aggressive tumor consequent to the accumulation of monoclonal plasma cell neoplasms and, due to the rarity of the disease, there are only few clinical studies reporting it especially regarding prognostic factors and treatment. Here, we report a fatal clinical case of SPB in Roraima, the northernmost state of Brazil. The study shows a case of solitary bone plasmacytoma on the femur, where the patient was submitted to the preconized radiotherapy cycles. However, over approximately four-years following the diagnose, the patient required multi-modal approach to guarantee quality of life during the survival time. Finally, this study explores SBP-related issues and examines the challenges physicians face when managing the care of patients with SBP.

Benefits of radiotherapy for patients with solitary plasmacytoma or multiple myeloma

Treatment options for patients with solitary plasmacytoma (SP) or multiple myeloma (MM) should be discussed in an interdisciplinary context. This systematic review focuses on the importance of radiotherapy in MM and SP. Summary of local radio-oncological treatment options for patients with SP and MM. Based on asystematic literature search, the current evidence on the topic was analyzed and summarized. Patients with SP should be primarily treated with radiotherapy with or without surgery. Irradiation concepts may vary depending on risk factors and manifestation (solitary bone plasmacytoma vs. solitary extramedullary plasmacytoma). Although local control rates are high after radiotherapy, progression to multiple myeloma frequently occurs. In patients with MM, radiation is mainly used in palliative settings for pain relief, prevention of fractures or in patients who suffer from neurological symptoms due to spinal cord compression. Irradiation dose and fractionation should be selected based on treatment indication and general condition of the patient. Although most patients receive systemic treatment at initial diagnosis, approximately 40% of patients with MM will require radiation during the course of their disease. While radiation is mainly used for palliation in patients with MM, it represents the primary and curative treatment option in patients with SP.

The Analysis of Risk for Solitary Bone Plasmacytoma Rapidly Progressing to Multiple Myeloma

Background:Solitary bone plasmacytoma(SBP) is a very rare and heterogeneous disease. Some patients have rapid progress into multiple myeloma. But some patients stay stable for a long time. Different patients have different clinical processes and prognostic performance. At present, there is no inconclusive prognostic factors of SBP progressed into multiple myeloma，and different studies have great different results. and they did not ues modern detection technology and methods. Therefore, there is no easy reliability methods for the factors of SBP progressed into multiple myeloma. There could not screen the SBP that rapidly progressing to MM and give intervention treatment for them.Purpose:to analyze the clinical characteristics and lesion biological markers of SBP patients using body PET / CT, flow cytometry and immunocellularization to and screen out the high-risk SBP patients who rapid progress into MM. SBP patients divided into different stratification according with high risk factors. And we preliminary establish the prognostic risk assessment systems which could predict SBP progressed into multiple myeloma.Objects and methods:Case: This study retrospectively analyzed 41 patients who were hospitalized from January 2003 to January 2020.All these patients accorded with the diagnostic standard of 2018 European solitary plasmacytoma .Enrolled 41 patients in groups. Observation indicators: age, gender, hemoglobin, β2 microglobulin, lactic acid dehydrogenase, blood calcium, creatinine,uninvolved immunoglobulin inhibited, M protein,X-ray / computed tomography (CT) / Magnetic Resonance Imaging(MRI) or whole body PET / CT, bone marrow smear, flow cytometry of bone marrow, the immunohistochemical conditions of the puncture lesion include VCAM-1, MMP9, VEGF, TGFβ, IGF-1, Ki-67, p53, CXCR4, 67LR, MCP-1, CCR2, CCR7.Results:1. General Characteristics: A total of 41 patients with SBP are enrolled in this study, The median age of onset is 53.02 years (20-73 years), and 22pts are males and 19pts females. The median follow-up time is 48 months, and during this time, 17 patients progressed into multiple myeloma.The median PFS is 84 months.For the significance of lesions, the lesions were in vertebral body of 16 cases (39.0%), 7 cases (17.1%), respectively in scapular, rib and clavicle. For treatment, 20 patients (48.8%) were received radiotherapy, 16 patients (39.0%) received surgery + radiotherapy, and 5 (12.2%) patients just only accepted surgery.Among 41 SBP, 17 patients(41.5%) progressed into MM during follow-up, including 8 cases (8/17)progressed within 1 year after diagnosis. 3 cases progressed between 1 to 2 years, and 3 cases between 2 to 4 years.Also 3 patients progressed above 4 years after diagnosis.2. In single-factor and multi-factor analysis, the progress group and the disease stabilization group are independent adverse pre-factors affecting SBP progress into MM ,including the vertebral body (p =0.028), excition clone plasma cell in BM (p =0.010)and the proportion of ki67 positive cells> 12.5%(p =0.019).3. Establish formula model to predict the prognosis of SBP progressed into MM.On the base of beta Predicting prognosis = lesion is located in vertebral body × 2 +excited clone plasma cell in bone marrow × 3 + ki67 > 12.5% × 4. According to the model, the score is between 0 points to 9 points, the scores <2 are divided into low-risk group, and scores between 2 ~ 5 are divided into middle-risk group.When scores≥5 are divided into high-risk group. Among the 41 patients in this study, 15 patients (36.6%), are the low-risk group that PFS has not been achieved.And 11 patients (26.8%) are the middle-risk group ,which PFS is 8.3% of 2-year. Verify the prediction prognostic model of SBP progressed into MM. There are six cases of SBP which include the prognosisi factors can be used to verify our model in Guidong People's Hospital, Guangxi. These 6 patients are identical with our prognosis model.Conclusions:SBP patients divided into different stratification according with high risk factors. The vertebral body, excition clone plasma cell in BM and the proportion of Ki67 positive cells> 12.5% are the independent adverse pre-factors for SBP progressed into MM. According the score of our model,SBP can be divided into low-risk, middle-risk groups and high-risk groups. It may require early intervention for high-risk patients that progressed into multiple myeloma within 2 years. DisclosuresNo relevant conflicts of interest to declare.

Prognostic Nomogram for Predicting Overall Survival of Solitary Bone Plasmacytoma Patients: A Large Population-Based Study.

BackgroundThe aim of the study was to develop a nomogram to predict the overall survival (OS) of patients with solitary plasmacytoma of bone (SBP).Materials and MethodsPatients diagnosed with SBP between 1993 and 2012 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. All eligible patients were randomly allocated to the training sets and the validation sets. The nomogram was developed with the training set and validated with the validation set using the concordance index (C-index), calibration plots, and decision curve analyses (DCA).ResultsAge, marital status, tumor grade, treatment were independent prognostic indicators for OS (P<0.05) and were integrated to construct the nomogram. C-indexes for OS prediction in the training and validation sets were 0.78 and 0.73, respectively. The calibration plots demonstrated good consistency between the predicted and actual survival. DCA demonstrated that the new model has great benefits. In the total cohort, the median OS of patients in the low- and high-risk groups were 12.17 (95% CI 11.92–12.42) and 3.92 (95% CI 2.83–5.01) years, respectively.ConclusionThe nomogram showed excellent applicability and accuracy, which could be a reliable tool for predicting OS in SBP patients.

Solitary bone plasmacytoma of spine with involvement of adjacent disc space: A case report.

RationaleSolitary bone plasmacytoma (SBP) is a rare manifestation of plasma cell tumor. Although axial skeleton is the most frequently affected site of SBP, adjacent disc space involvement is rare. Herein we report a case of SBP in thoracic vertebra with involvement of adjacent disc space.Patient concernsA 57-year-old male presented with a 2-year history of intermittent back pain with activity. The patient's back pain intensity with activity was a score of 5 of the 10-point visual analog scale).Diagnoses and interventionThe patient underwent a posterior fusion procedure from T6 to T10, and an open biopsy of the vertebral lesion confirmed that final diagnosis of SBP. The patient received postoperative radiotherapy with a total of 4000 Gy to the T7–T9 vertebral levels over a 20-day period.OutcomesFollowing radiotherapy, the patient's pain intensity was reduced to the visual analog scale score of 1 at the 6-month follow-up.LessonsSBP lacks typical clinical symptoms, and the accurate diagnosis before clinical intervention remains challenging. Due to the disc involvement, SBP often manifests as spinal infection. Hence, differential diagnosis in spinal lesions involving the disc should include SBP.

MM-050: Solitary Extramedullary Plasmacytoma of the Nasal Cavity Presenting as Nasal Polyp Causing Nasal Obstruction

Introduction Plasmacytomas are lymphoproliferative disorders characterized by monoclonal proliferation of plasma cells. Solitary bone plasmacytoma and extramedullary plasmacytoma are two subtypes of plasmacytomas. Only less than 10% of all plasmacytic tumors and less than 1% of head and neck tumors are accounted for by extramedullary plasmacytomas. They most commonly occur in the submucosa of the upper respiratory tract. The risk of conversion to multiple myeloma is unclear but is certainly less than that with solitary bone plasmacytoma. Extramedullary plasmacytoma of the nasal cavity can present with nasal obstruction, epistaxis, rhinorrhea, facial swelling, and pain. Case Report We present a case of solitary extramedullary plasmacytoma of the left inferior turbinate in a 54-year-old female who presented with progressive left nasal obstruction and difficulty breathing. Nasal endoscopy showed a large polyp growing from the left inferior turbinate causing 100% obstruction. Excisional biopsy was consistent with plasmacytoma. Whole-body PET/CT showed no evidence of disease and no bony destruction or abnormal uptake in the nasopharynx and nasal cavity. Serum electrophoresis, urine electrophoresis, bone marrow aspirate biopsy, and other screening tests showed no evidence of multiple myeloma. Diagnosis of solitary extramedullary plasmacytoma of the nasal cavity was confirmed. The patient was then treated with adjuvant radiation therapy to the left inferior turbinate for a total dose of 45 Gy, given in 25 fractions. Conclusion Extramedullary plasmacytoma of the nasal cavity is a rare, slow-growing tumor that can present as a nasal polyp causing nasal obstruction. Diagnosis can be missed if these nasal polyps are not biopsied. Radiotherapy is the treatment of choice. Complete surgical resection is also suggested based on the size and resectability. The role of chemotherapy is unclear. The optimal follow-up protocol for extramedullary plasmacytoma of the nasal cavity is unclear due to the rarity of this tumor and the lack of randomized clinical trials.

MM-338: Factors of an Unfavorable Prognosis in Patients with Solitary Plasmacytoma Among Residents of the Gomel Region of Belarus

Introduction Solitary plasmacytoma is a tumor of plasma cells with local proliferation without signs of systemic damage and a high risk of progression to MM. Depending on the presence of a lesion in the bone or soft tissues, there are solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. There are currently few data available on prognostic factors. Methods The study included 24 patients (4 SEP patients, 20 SBP patients) of the Gomel region (Belarus) 2018–2021 with different anatomical localization. The diagnosis was histologically confirmed. The average age was 62 (from 41 to 79 years); female patients prevailed 54.2% (13/11). All patients underwent aspiration biopsy with IFT and FISH, trepanobiopsy with immunohistochemical examination of the BM, and X-ray examination of the skeletal bones. Results were assessed after 3 years of observation. The signs of progression include the appearance of any one of the CRAB-criteria. Results The presence of clonal PCs 5 cm) were detected in 4 patients (all progressed to MM). The progression of the disease to MM was recorded in 7 patients (29.2%). The period to progression was 10 months (media) (3–18). An immunophenotypic study in these patients revealed a significant decrease in the CD95 level (p = 0.001) and in 71.4%, a significant excess of the TNF-a level (p = 0.001) and a significant excess of the B2 microglobulin level (p = 0.001). The 3-year survival rate was 100%. Local relapse developed after 4 courses of PAD in 1 patient who progressed to MM. Conclusion The progression of the disease in patients was associated with the presence of cytogenetic changes in combination with the presence of aberrant or clonal cells in BM 5 cm).

Safety and Feasibility Analysis of a Prospective Trial on Stereotactic Body Radiotherapy for Solitary Bone Plasmacytoma

Background: There have been reports on the use of hypofractionated stereotactic body radiotherapy (SBRT) for bone plasmacytomas, but no prospective data are available. We present the initial analysis of an ongoing prospective protocol on SBRT addressing the feasibility and safety of this treatment for solitary bone plasmacytomas. Patients and Methods: A prospective cohort of SBRT for solitary bone plasmacytoma was developed. Patients could receive different doses depending on the index bone, from single fraction for skull base lesions, 24 Gy in 3 fractions for spine lesions, and 30 Gy in 5 fractions for other bones. Overall survival, bone events, local control, and progression to multiple myeloma (MM) were measured and compared to our retrospective cohort of patients treated with conformal standard-dose radiotherapy. Quality of life was assessed via the EORTC QLQ-C30 questionnaire, and toxicities were assessed by the CTCAE v5.0 criteria. After 1 year or the inclusion of 5–10 patients, a feasibility and safety analysis was programmed. Results: Between April 2018 and April 2019, 5 patients were included. All were male, with a median age of 53.1 years. The median follow-up was 21.8 months. No patient had local progression, bone event, or died. Two patients had progressions to MM. The mean survival free of progression to MM was 18.6 months, compared to 19 months in the retrospective cohort; median values were not reached. There were no grade 3 toxicities. Conclusion: SBRT for plasmacytoma is safe and feasible. More robust data are awaited.

Prognosis of solitary bone plasmacytoma of the extremities: A SEER-based study.

Due to the rarity of solitary bone plasmacytoma (SBP), few studies reported the prognosis and survival predictors of SBP, especially for patients with extremity SBP.A total of 552 patients with extremity SBP were identified from the Surveillance Epidemiology and Ends Results (SEER) database between 1973 and 2016. In order to obtain independent predictors of survival, we performed both univariate and multivariate analysis via Cox proportional hazards model. Additionally, we used the Kaplan-Meier method to construct survival curves.The mean and median age at diagnosis of all patients were 64 and 65 years, respectively. The ratio of male versus women was 1.3:1. Overall survival for this special population was 51.2% and 34.9% at 5 and 10 years, respectively. Cancer-specific survival (CSS) for this special population was 63.5% and 47.5% at 5 and 10 years, respectively. Age at diagnosis and radiotherapy treatment were found to be significant independent predictors of both overall survival and CSS. Additionally, multivariate analysis showed that year of diagnosis and marital status were significantly correlated with CSS.This is the first study to identify prognostic factors of extremity SBP by using the SEER database. Our findings highlight that radiotherapy is the mainstream treatment for extremity SBP. Additionally, age, year of diagnosis, and marital status were significant independent predictors of survival. Knowledge of these survival predictors may help clinicians provide appropriate management for extremity SBP patients.

Solitary Plasmacytoma of The Jaws: Therapeutically Considerations and Prognosis: A Case Report

The plasma cell neoplasm is a rare malignant neoplasm of plasma cells that may present as Extramedullary Plasmacytoma (EMP) in soft tissues especially in the upper respiratory tract, in the bone as a Solitary Plasmacytoma of bone (SPB), or as a part of the multifocal disseminated disease as Multiple Myeloma (MM). The majority of 80% occurs in the head and neck region. In our case, a 23-year-old female patient presented with a non-tender swelling of the gingiva in the upper and lower jaws with the mobility of all teeth. The radiological examination showed severe destruction of bone around all teeth.

Hallazgo casual de un plasmocitoma óseo solitario de costilla en una gammagrafía de receptores de somatostatina

Hallazgo casual de un plasmocitoma óseo solitario de costilla en una gammagrafía de receptores de somatostatina

Solitary plasmacytoma of the maxilla: A rare case report of identification and management within an oral surgery department

AbstractPlasmacytoma is a rare malignant tumour originating from the plasma cells. This may present itself in the bone marrow (myelomatous) as a solitary bone plasmacytoma or in the soft tissues, as an extramedullary plasmacytoma. Solitary bone plasmacytomas in the head and neck region are very uncommon and initial symptoms may be non‐specific and vague. However, the risk of progression towards multiple myeloma with these conditions is high, and therefore early diagnosis is essential for positive therapy outcomes. An 81‐year‐old patient presented with a pedunculated soft tissue mass in the upper left maxilla. This demonstrated symptoms in keeping with a pyogenic granuloma; however, the rapid growth and haemorrhagic nature raised concerns. Histological examination of the maxillary soft tissue mass revealed dense plasma cell infiltrate, consistent with a solitary plasmacytoma. Extensive investigations were performed to exclude multifocal involvement. Treatment involved complete surgical excision and radiotherapy. The patient remained stable and progression free at 6‐month review. The objective of this clinical case report is to highlight this unusual oral pathology to avoid incorrect diagnosis.

Successful Vaccination of Patients with History of Severe Anaphylactic Reaction with Pfizer-Biotech COVID-19 Vaccine

Plasmacytomas are localized tumors of monoclonal plasma cells, typically affecting the axial skeleton and present as solitary bone lesions known as solitary bone plasmacytomas (SBP). Another type of plasmacytomas are extramedullary plasmacytomas (EP) that are localized plasma cell neoplasms affecting the soft tissues such as skin, brain lymph nodes etc. These tumors are account for 5-10% of all plasma cell disorders and among these tumors a rare entity is a multiple solitary plasmacytoma (MSP). MSPs are rare and account for only 5% of all SBPs. MSP presents with multiple SBPs with or without EPs with no bone marrow involvement as multiple myeloma. Literature is limited on MSP as it is a rare diagnosis. Here, we present a case of a 64-year-old male who presented with shoulder pain after a fall, found to have an SBP of the right shoulder, SBP of left femur and a left hypopharyngeal EP. The tumors were excised and he was treated with 6 cycles of bortezomib and dexamethasone. After chemotherapy and radiation patient showed good response and remained in remission on follow up.

Pathological axis fracture secondary to a solitary bone plasmacytoma: Two cases and a literature review.

Background: Solitay bone plasmocytoma (SBP) account for just 5–10% of all plasma cell neoplasms. They are infrequent in the cervical spine, especially involving the C0–C2 segment. In this article we conducted a literature review and present the diagnosis, management and long term course of two patients with SBP of C2 causing cervical instability.Methods: We assessed the clinical records of two patients with SBP in C2 and cervical instability attributed to SP-B involving C2. Both patients presented with progressive, severe cervicalgia, and the “sensation” of skull instability. Magnetic resonance imaging revealed an extensive, infiltrative lesion involving C2 vertebral body and lateral masses, consistent with a plasmacytoma.Results: Both patients underwent emergency posterior surgical stabilization with craniocervical fixation; this was accompanied by a C2 transpedicular biopsy. Postoperatively, patients exhibited no focal neurological deficits and rapidly became pain free. They additional recieved 25 sessions of local conventional radiation therapy. Both patients are doing well as respective 2 and 7-year follow-up.Conclusion: Although rare, unstable SBP may present atypical cervical location that readily responds to surgical descompression/fusion and radiotherapy.

PET/CT F18-FDG with soft tissue plasmacytomas in multiple myeloma

Multiple myeloma is characterized by malignant proliferation of clonal plasma cells. Usually, appears as a generalized disease but it can present as solitary bone plasmacytoma or a solitary soft tissue mass or extramedullary plasmacytoma. In the case of extramedullary involvement, it could present as soft tissue plasmacytomas and the prognosis is poor. The 18F-FDG PET/CT could be a valuable tool for characterization of the medullary and extramedullary involvement. We present a case of F18-FDG PET/CT with extramedullary involvement with soft tissue plasmacytomas in the setting of MM.

Successful treatment of solitary bone plasmacytoma and bone remineralisation with novel biological agents leading to new bone formation – a case series

Successful treatment of solitary bone plasmacytoma and bone remineralisation with novel biological agents leading to new bone formation – a case series