Solitary Extramedullary Plasmocytoma Research Articles

MM-230: Solitary Extramedullary Plasmocytoma Mimicking a Primary Breast Cancer

Extramedullary plasmocytoma is a plasma cell neoplasm that arises outside the bone marrow in the absence of any other sign of multiple myeloma. Breast plasmocytoma has been reported as part of disseminated disease. However, primary solitary breast plasmocytoma is rarely described. Here, we present a case of solitary extramedullary breast plasmocytoma mimicking a primary breast tumor. A 50-year-old female patient presented to our clinic for a left breast lump of one month duration without any associated systemic symptoms. Mammography and breast ultrasound showed a suspicious, well-defined, 2-cm mass in the left upper quadrant without ipsilateral lymphadenopathies. Tru-cut biopsy from the breast lesion revealed unexpectedly atypical monoclonal plasma cells (kappa monoclonality). Serum protein electrophoresis and immunofixation of serum protein, as well as urine protein electrophoresis and Bence Jones proteins, were negative for any M-protein/monoclonal gammopathy. Bone marrow aspirate and biopsy disclosed less than 3% clonal plasma cells. 18F-FGD PET-CT did not show any lytic lesions nor other pathologic findings. These results supported the diagnosis of solitary extramedullary plasmocytoma of the breast. Subsequently, our patient was referred for wide local excision of the solitary lesion. She received a consolidative radiation therapy post-operatively. Fifteen months later, the patient is on regular follow-up without detection of any monoclonal gammopathy. Usually, extramedullary plasmocytoma occurs in the head and neck. Few cases are reported in the breast. Clinicians should be aware of this entity, mimicking primary breast cancer. It does not have specific clinical or radiological features. The diagnosis requires: extramedullary tumor with evidence of clonal plasma cells, normal skeletal survey, no M-protein in serum and/or urine, and no bone marrow involvement. Soft tissue extramedullary plasmocytomas have better prognosis than plasmocytomas occurring in bone. The treatment of choice is radiation therapy with curative intent and low risk of recurrence after tumoricidal radiation.

Relapse of Multiple Myeloma in the Thyroid Gland

Multiple myeloma (MM) relapse following allotransplantation is rare, and when it does occur, it tends to be located in the bone marrow. Thyroid gland invasion by plasma cells is an uncommon finding in the literature. It is important to be aware that in some patients the disease manifests as apparent solitary extramedullary plasmocytoma, though further investigation reveals a plasma cell tumor in other sites We present a case of relapsed MM presenting as a rapidly growing thyroid mass.

Solitary Extramedullary Plasmocytoma of the Thyroid Gland: A Case Report

Solitary extramedullary plasmocytoma (SEP) of the thyroid gland is a very rare disease. The diagnosis of SEP can be made after ruling out multiple myeloma. Histological examinations, immunohistochemical analysis with an overexpression of CD 138, CD 38 and kappa light chain reaction confirmed this uncommon condition in our case. Medullary carcinoma, MALT-Lymphoma and Non-Hodgkin Lymphoma of the thyroid should be excluded in the diagnosis. Surgical resection and radiotherapy, or a combination of both, are standard treatment methods. However, because of rareness of this disease, no general therapy can be recommended. We report about a 75 year old male patient and its involvement of the right remainder thyroid lobe by SEP five years post a Dunhill-Procedure due to multinodular goiter.

Pozaszpikowa pierwotnie skórna postać szpiczaka mnogiego

Pozaszpikowa pierwotnie skórna postać szpiczaka mnogiego

Solitary extramedullary plasmocytoma of the thyroid: a case report and histological approach to plasma cells infiltrate in the thyroid gland

Background:Solitary extramedullary plasmacytoma (SEP) is a rare malignant neoplasm arising from plasma cells. SEP mostly occurs in the upper respiratory tract. Thyroid gland is rarely affected (<78 cases).Methods/results:We describe the case of a 78-year-old woman presenting a rapidly enlarging palpable thyroid mass. Neck computed tomography scan showed enlargement of both thyroid lobes. Laboratory tests were normal, including serum protein level with no monoclonal gamma globulin peak. Cytology was suspicious for lymphoma. Biopsy showed an infiltrating neoplasm composed of atypical tumor cells with abundant cytoplasm and eccentric nuclei. These revealed diffuse immunoreactivity for CD138 and predominant staining for immunoglobulin kappa light chains. Clinical workup for multiple myeloma was negative.Conclusions:SEP should be considered in the differential diagnosis of a rapidly enlarging thyroid nodule and be distinguished from involvement of thyroid in multiple myeloma, mucosa-associated lymphoid tissue lymphoma, plasma cell granuloma and medullary carcinoma. Clinical correlation and immunohistochemistry are crucial in avoiding pitfalls.

Solitary extramedullary plasmocytoma of the liver

Solitary extrameduallary plasmacytomas represent approximately 3% of all plasma cell neoplasms. Extramedullary plasmacytoma of the liver is a very rare tumor, although a few cases of extramedullary plasmacytoma of the liver have been reported. We report an unusual case of liver plasmacytoma without systemic disease, diagnosed by percutaneous needle biopsy of the hepatic lesion. The patient was a 67 year old female who exhibited a solitary liver mass on dynamic computed tomography (Panel A). We performed percutaneous needle biopsy of the hepatic lesion. Histologically, the tumor was composed of CD 138 positive plasma cells with mild atypia (Panel B: H&Ex40 black arrow), and 80% of them demonstrated Kappa light chain (Panel C: H&Ex40 red circle – white arrow). There was no evidence of a monoclonal protein in the serum and urine, lytic bone lesions, anemia, renal insufficiency, or hypercalcemia. The bone marrow examination revealed no abnormalities. The patient was treated with local radiation and is doing well without further evidence of disease after one year of follow-up. Primary extramedullary plasmacytoma (EMP) is defined as an extraosseous proliferation of neoplastic plasma cells, without evidence of bone or B

Extramedullary Plasmacytoma of Maxillary Sinus

Solitary extramedullary plasmacytomas are rare tumors that often affect the head and neck region. Diagnosis of solitary extramedullary plasmocytoma can be confirmed only when the presence of systemic disease is excluded by performing clinical, biological, and radiological investigations. Radiotherapy is considered the treatment of choice, surgery being limited to biopsy and to excision of residual disease. We report herein the case of a 62-year-old man with an extramedullary plasmacytoma arising in the left maxillary sinus who was referred for chemoradiotherapy.

Endoscopic endonasal medial maxillectomy: case series

A medial maxillectomy (MM) consists of a complete resection of the medial wall of the maxillary sinus. Traditionally the surgery is performed via an open approach. With more familiarity and expertise in endoscopic sinus surgery the endonasal approach is feasible. To expose the surgical technique and report the results of endonasal endoscopic MM in a series of 6 consecutive patients. Between August 2006 and October 2009, 6 patients were operated with this procedure. All were men. The mean age was 62-year-old (range: 43-83). In 5 cases, the surgery was performed for inverted papillomas confined to the maxillary sinus. In one case it was a primary surgery whereas it was a revision surgery for the others. The sixth patient was operated for a solitary extramedullary plasmocytoma inserted on the intersinonasal wall persistent after an external radiation therapy. All the patients are free of disease at the time of writing with a mean follow-up of 18,2 months (range: 9-38). This has been confirmed by a nasal endoscopy and CT scans. There were no major per or postoperative complications. Patients suffered from crusting for at least 6 months postoperatively necessitating daily nasal douches. One patient is still complaining of intermittent epiphora when he is exposed to wind. Endoscopic MM can be successfully performed for the resection of expanding processes involving the maxillary sinus and/or the intersinonasal wall. Compared to open approaches, it seems to be as effective with less postoperative morbidity. An important technical point is to do the anterior osteotomy in front of the nasolacrimal duct in order to expose the prelacrimal recess that is typically an area for possible recurrence. Exact determination of the tumor attachment during the surgery is another key point for success.

Plasmocytome solitaire extramédullaire de la tête et du cou : à propos de cinq cas

PurposeTo assess the outcome and the management of solitary extramedullary plasmocytoma in the head and neck region. Patients and methodsFrom 1997 to 2008, five cases of solitary extramedullary plasmocytoma were treated in the department of radiotherapy at Salah-Azaiz Institute. Three patients had a solitary plasmocytoma of the nasal fossa; the others were ethmoidal and submandibular node. All patients received irradiation of 40 to 45Gy in the primary site associated to surgery in four cases. Among the five patients, two had radiotherapy after recurrence. ResultsFour complete responses were noted with a follow-up of 12, 36, 52 and 72months. Multiple myeloma occurred in one patient 8years after treatment. ConclusionRadiotherapy is the best effective local treatment. Local control of extramedullary plasmocytoma in the head and neck region seems to be improved when the dose is at least 45Gy. Predictive parameters of unfavourable outcome and conversion of extramedullary plasmocytoma to multiple myeloma should be better defined.

Plasmocitoma solitario extramedular de amígdala tubárica

Several histopathological modalities of tumours can grow in the rhinopharynx. Solitary extramedullary plasmocytoma (SEP) is a low frequent variety of low-grade lymphoma. The aim of this work is to present a new case of SEP localized in rhinopharynx and to perform a review of diagnostic and therapeutic protocols of these neoplasias. They must be taken into account in the differential diagnosis of nasopharyngeal tumours.

Solitary extramedullary plasmocytoma of tubaric tonsil

Several histopathological modalities of tumours can grow in the rhinopharynx. Solitary extramedullary plasmocytoma (SEP) is a low frequent variety of low-grade lymphoma.The aim of this work is to present a new case of SEP localized in rhinopharynx and to perform a review of diagnostic and therapeutic protocols of these neoplasias. They must be taken into account in the differential diagnosis of nasopharyngeal tumours.

Coexistence of erythrocyte agglutination and EDTA-dependent platelet clumping in a patient with thymoma and plasmocytoma.

For 8 years, EDTA-dependent pseudothrombocytopenia was observed in a 55-year-old woman with a history of rheumatoid arthritis who had undergone surgery for lymphoepithelial thymoma 11 years earlier. The clinical picture was characterized by the presence of platelet clumps and antiplatelet antibodies of the IgM class. With the recent appearance of a solitary extramedullary plasmocytoma in the right retrobulbar region and the detection of an IgGlambda monoclonal gammopathy, blood examination also revealed erythrocyte agglutinates alongside the platelet clumps and the presence of a cold IgG antibody with antiI specificity. Both phenomena were observed in vitro when the sample temperature declined to 20 degrees C to 25 degrees C, but not at 37 degrees C. While the EDTA-dependent antiplatelet antibodies did not appear to be chronologically correlated with the patient's diseases, the cold antierythrocyte autoantibodies were strictly related to the plasmocytoma and the IgGlambda monoclonal component in serum. To our knowledge, this is the first description of an association between EDTA-dependent platelet and erythrocyte agglutinates, with a clinical picture of pseudothrombocytopenia and pseudoerythrocytopenia due to cold agglutinins.

Primary plasmocytoma of the breast

A case of solitary extramedullary plasmocytoma of the breast is described. The tumor, observed in a 79-year old woman, measured about 15 × 15 cm, and showed the clinical aspect of mammary sarcoma. This is the third case of mammary plasmocytoma in the literature.