Pdf diagnosis, treatment, and response assessment in solitary. This may possibly be combined with a stem cell transplant. In approximately 20% of the cases involvement of other bones like rib, sternum, scapula, or clavicle have also been reported 10. Solitary plasmacytoma, extramedullary plasmacytoma, myeloma, plasma cell dyscrasia, petct, mri, radiotherapy. Find out about solitary myeloma symptoms, diagnosis and treatment. Diagnosis and management of solitary plasmacytoma of bone. Local radiotherapy is the treatment of choice for solitary bone plasmacytome sbp. Ask your doctor to recommend what other types of doctors, physicians, medical specialists, or other medical professionals should be part of the team for your medical issues. Extramedullary plasmacytomas happen when a plasmacytoma develops in the lungs, throat or other organs.
Solitary plasmacytoma of the bone spb is a malignant proliferation of plasma cells that occurs within the axial skeleton and is characterized by destruction of the bone. They then need additional treatment, such as chemotherapy. Solitary bone plasmacytoma sbp progresses to multiple myeloma at a rate of 6584% at 10 years and 65100% at 15 years. Multiple myeloma is a type of blood cancer of the plasma cells which are found in the bone marrow. Solitary plasmacytoma occurring in bone definition solitary plasmacytoma s are single localized tumors consisting of monoclonal plasma cell s with no clinical features of plasma cell myeloma pcm see 97323 and no physical or radiological evidence of additional plasma cell tumor s. Solitary bone plasmacytomas is an uncommon plasma cell tumor which is localized to bone. If the cancer is located in only one part of the body it is called a solitary plasmacytoma and if there are multiple sites it is called a multiple myeloma. Radiation therapy is the commonly used treatment for both the types of solitary plasmacytoma, as solitary plasmacytomas are localized and there is only one tumor present. This section presents information about some of the possible medical professionals that might be involved with solitary plasmacytoma.
The case of a 56yrold man is presented, who had a massive tumor of the right pulmonary apex. Overall, plasmacytomas are more commonly seen in african americans than asians. Solitary plasmacytomas represent approximately 5% of all patients with myeloma. These tumors may be described as localized or diffuse in. Of the extramedullary plasmacytomas, 80% occur in the head and neck, usually in the upper respiratory tract. To discuss the clinical characteristics, therapeutic methods and factors affecting prognosis of sp in the cervical spine summary of background data. The diagnosis and treatment of other plasma cell disorders eg, solitary extramedullary plasmacytoma, mm, primary al amyloidosis, monoclonal gammopathy of undetermined significance are discussed separately. The most common of these is spb, accounting for 35% of all plasma cell.
Solitary plasmacytoma of the liver is a very rare and aggressive form of plasma cell dyscrasia. Extramedullary plasmacytoma carries a better prognosis than a solitary plasmacytoma of the bone. A plasmacytoma is a discrete, solitary mass of neoplastic monoclonal plasma cells in either bone or soft tissue extramedullary. Solitary plasmacytoma and extramedullary plasmacytoma of. Malignant bone tumours of the spine are extremely rare pdf solitary plasmacytoma is a rare disease characterized by a localized proliferation of neoplastic monoclonal plasma cells, without evidence of. Solitary plasmacytoma comprises 24% of cases of plasma cell myeloma. Plasmacytoma genetic and rare diseases information. The solitary plasmacytoma sp is characterized by a localized accumulation of neoplastic monoclonal plasma cells without a proof of a systemic plasma cell proliferative disorder. Among all plasmacytoma cases, solitary bone plasmacytomas account for about 5%.
Treatment approaches and outcomes in plasmacytomas. Adjuvant chemotherapy has been administered with inconclusive results. Plasmacytoma is a plasma cell dyscrasia in which a plasma cell tumour grows within soft tissue or within the axial skeleton the international myeloma working group lists three types. When plasma cells become cancerous and grow out of control, they can create a tumor called a plasmacytoma, usually in a bone or other tissue. Additional information is now available on the role of serum free light chains and pet scanning. Solitary bone plasmacytoma radiology reference article.
Surgery combined with radiotherapy for the treatment of. Plasmacytoma is a localized mass of neoplastic monoclonal plasma cells that represents approximately 5% of all plasma cell neoplasms. Radiation therapy for the solitary plasmacytoma journalagent. Solitary extramedullary plasmacytomas sep, solitary extraosseous plasmacytoma are plasma cell tumors that arise outside of the bone marrow.
We present the case of a 44yearold han chinese man who was diagnosed with a solitary plasmacytoma of the bone located in the right sixth rib. This is possible because by definition, solitary plasmacytomas are localised. Radiation therapy for solitary plasmacytoma and multiple myeloma. The prognosis and treatment of solitary plasmacytomas is very different to multiple myeloma. Learn about myeloma plasmacytoma solitary myeloma and how it differs from multiple myeloma. The treatment that is used most commonly for both types of plasmacytoma is radiotherapy. What is the prognosis of solitary bone plasmacytoma sbp. Diagnosis of a solitary plasmacytoma requires a very thorough evaluation. Softtissue or nonosseous extramedullary plasmacytoma emp solitary bone plasmacytoma sbp multifocal form of multiple myeloma multiple myeloma plasmablastic sarcoma t. Solitary plasmacytoma of bone spb, also called osseous plasmacytoma is a localized tumor in the bone comprised of a single clone of plasma cells in the absence of other features of mm ie, anemia, hypercalcemia, renal insufficiency, or multiple lytic bone lesions. Consider clinical trials as treatment options for eligible patients. Ct scan of the plasmacytoma should be obtained prior to radiation therapy. Treat as plasmacytoma, see page 2 yes no 1 see physical activity, nutrition, and tobacco cessation algorithms.
A solitary plasmacytoma is a discreet, single mass of abnormal cancerous plasma cells which can occur in bone or in soft tissue. Most people with extramedullary plasmacytomas can be cured after the treatment of radiation therapy. Localized variant can occur in bone or in soft tissues extramedullary from 1. A brain magnetic resonance imaging mri revealed an enhanced mass. Pdf solitary plasmacytoma is a rare disease characterized by a. In terms of clinical course, multiple solitary plasmacytomas can arise from a solitary plasmacytoma of bone or result from recurrent multiple myeloma 23 years after local radiotherapy or surgical resection. The clinical course, the response to treatment and the propensity to. Solitary plasmacytoma of the bone can sometimes be cured with radiation therapy or surgery to destroy or remove the tumor.
Primary solitary plasmacytoma of the liver successful. Solitary and extramedullary plasmacytoma page 1 of 4. Pdf solitary plasmacytoma is an infrequent form of plasma cell dyscrasia that presents as a single mass of monoclonal plasma cells, located. Solitary plasmacytoma sp is a plasma cell disorder characterized by localized accumulation of neoplastic monoclonal plasma cells in bone, or in soft tissues with no skeletal component, without any evidence of systemic involvement as demonstrated by the lack of clonal plasma cells in the bone marrow and absence of features of endorgan damage. In terms of clinical course, multiple solitary plasma cytomas can arise from a solitary plasmacytoma of bone or result from recurrent multiple myeloma 2e3 years. Solitary or extramedullary plasmacytoma memorial sloan. Standard treatment for solitary plasmacytoma is irradiation to the entire lesion with appropriate margins. In general, the risk of progression to myeloma is higher in patients with a solitary bone plasmacytoma sbp compared to those with. Surgical treatment for a giant solitary plasmacytoma with. A multiplicity of multiple solitary plasmacytoma lesions was noted only after radiologic evaluation in five of the six cases. For spinal lesions, the margins should include at least 1 uninvolved vertebra.
Solitary plasmacytoma symptoms, diagnosis, treatments and. Radiation therapy for solitary plasmacytoma and multiple. Solitary plasmacytoma is an infrequent form of plasma cell dyscrasia that presents as a single mass of monoclonal plasma cells, located either extramedullary or intraosseous. Solitary plasmacytoma multiple myeloma texas oncology. Original article the outcome and analysis of different. Treatment of multiple solitary plasmacytomas with cytokine. Solitary bone plasmacytoma is one of the two subgroups of plasmacytoma, the. Solitary plasmacytoma in mandible with 7 year follow up data. Guidelines on the diagnosis and management of solitary. Since the previous guideline several new articles on prognostic factors, treatment and outcome in patients with solitary plasmacytoma of bone have been published.
We report four cases of solitary plasmacytoma of the bone and an extramedullary plasmacytoma of the paranasal sinuses and soft palate. It is most commonly found in the thoracic vertebrae but can also be seen in following order in other vertebrae lumbar, sacral, and cervical vertebrae 9. They are found in the bone marrow of the axial skeleton or long bones of limbs. The patient presented with a 4year history of continuous pain in the right chest area and moderate fever lasting 7 days. They are solitary lesions, and are most often located in the head and neck region, mainly in the upper aerodigestive tract, but may also occur in the gastrointestinal tract, urinary bladder, central. In some patients, a bone marrow aspiration can detect a low monoclonal plasma cell infiltration which indicates a high risk of early progression to an overt myeloma disease. A 64yearold white french man had monoclonal gammopathy of the. Clinical features and prognostic factors in solitary.
A type of cancer from plasma cells where the plasma cells multiply uncontrollably. They are solitary lesions, and are most often located in the head and neck region, mainly in the upper aerodigestive tract, but may also occur in the gastrointestinal tract, urinary bladder, central nervous system, thyroid, breast, testes, parotid gland, lymph nodes, and skin. Although some studies have found that adjuvant therapy may prevent or delay progression to myeloma, most have noted no benefit with the early administration of chemotherapy. Currently, radiation therapy remains the primary choice of treatment for spb, as plasmacytoma is a radio. A consecutive series of 19 cases of solitary plasmacytoma sp of cervical spine that underwent surgical treatment and one case that underwent pure radiotherapy were observed from 1995 to 2006 objective.
We reported a rare case of hepatic solitary plasmacytoma that successfully responded to fractionated stereotactic radiotherapy. Solitary and extramedullary plasmacytoma md anderson. In this article, the authors presented a 40yearold man who had a painless protruding mass over the midline of the posterior head region. In radiation therapy, there is focusing of radiation on the solitary plasmacytoma to destroy the abnormal cancerous cells. On an annual basis, about 1,000 new cases of solitary plasmacytoma are reported. Some patients diagnosed with a solitary plasmacytoma will go on to develop myeloma. It is an infrequent form of plasma cell neoplasm and represents 5% to 10% of all plasma cell neoplasms according to the literature 15. A solitary plasmacytoma is a single cancer site that may involve the bone osseous or other tissues extraosseous or extramedullary. Doctors and medical specialists for solitary plasmacytoma. The treatment used most commonly for both types of plasmacytoma is radiotherapy. Solitary bone and extramedullary plasmacytoma hematology.
The treatment is generally given over several days to reduce sideeffects. Radiotherapy involves focusing radiation similar to xrays on the plasmacytoma to kill the abnormal cells. Solitary plasmacytoma of the spine associated with. Each year, 5% of patients diagnosed with solitary plasmacytoma of bone progress to multiple solitary plasmacytomas. Plasmacytomas in four cases of multiple solitary plasmacytoma comprised multiple extramedullary plasmacytomas, whereas in two cases a bone. Radiotherapy is the common modality of treatment with, or without, adjuvant chemotherapy. Diagnosis, treatment, and response assessment in solitary. They may involve any bone, but they have a predisposition for the red marrowcontaining axial skeleton. Radiation therapy for treating solitary plasmacytoma. Tumour sizes were larger in patients with bone involvement p 0 003. Solitary plasmacytoma of the bone, especially of a single rib, is a rare disease. Solitary plasmacytoma of the skull, a single malignant monoclonal plasma cell proliferation without systemic involvement, is rare and often misdiagnosed by radiological examinations only. Solitary plasmacytomas are uncommon plasma cell disorders, which may present as a single bone lesion pbone or extramedullary plasmacytoma pem. However, 70 percent of people with solitary plasmacytoma eventually develop multiple myeloma.