Intrasellar plasmacytoma: An illustrative case and literature review

Khan, Imad Saeed; Javalkar, Vijayakumar; Thakur, Jai Deep; Nanda, Anil

doi:10.1016/j.jocn.2011.07.009

Cited by 12 publications

(20 citation statements)

References 25 publications

(18 reference statements)

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“…In prior series, patients with MM were treated with chemotherapy, at times with adjuvant radiotherapy [55,51,52]. Response rates to radiotherapy in these patients are 80–90%, with a 74% overall survival rate, a 50% disease-free survival rate, and an 86% local control rate after 5 years [10].…”

Section: Discussionmentioning

confidence: 99%

Sellar and clival plasmacytomas: case series of 5 patients with systematic review of 65 published cases

et al. 2017

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Purpose Parasellar plasmacytomas are rare tumors localized to the sellar region arising from plasma cells. Knowledge of clinical, imaging, surgical, and pathological characteristics is limited to single case reports. Methods A retrospective analysis of 5 primary cases was conducted, followed by systematic review of English language articles using PubMed in accordance with PRISMA guidelines. Results Five primary case patients include four men and one woman, ages 60–77, followed up to three years. A systematic review identified 65 additional patients, of whom 65% presented with cranial nerve palsies and 15% with hypopituitarism. Sixteen percent had history of known multiple myeloma (MM) while 37% were diagnosed concurrently with MM on presentation of parasellar plasmacytoma. Imaging showed median tumor size of 38 mm (range, 4–70 mm), with MRI intensity similar to that of other sellar masses. Surgical biopsy with immunohistochemical studies confirmed plasmacytoma diagnosis. Eighty-one percent underwent parasellar radiotherapy, and chemotherapy initiated in 59% of the 69 patients with MM. Overall survival rate was 74% at follow-up (median 12 months), with 18% having parasellar recurrences and 38% progressing to systemic MM after presentation of a solitary plasmacytoma (median 3 months). Conclusions Parasellar plasmacytomas are rare tumors that should be considered in the differential diagnosis for lesions involving the sella and arising from the clivus, especially when cranial nerve paresis is apparent, even in the absence of known MM. Although recurrence rates for parasellar plasmacytoma is low, patients should be monitored for progression to MM. Treatment depends on the presence of systemic disease at diagnosis.

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Section: Discussionmentioning

confidence: 99%

Sellar and clival plasmacytomas: case series of 5 patients with systematic review of 65 published cases

et al. 2017

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“…A review in 2012 collated all reported cases of plasmacytoma involving the sella turcica to that date by Khan et al 4 We add to these cases already reported in the literature, with that our patient, to review a total of 31 cases (Tables 1 – 3 ). In this review, we conclude the features of sellar plasmacytoma with or without association with MM.…”

Section: Discussionmentioning

confidence: 99%

Sellar Solitary Plasmacytoma Progressing to Multiple Myeloma

Jiang

Lin

et al. 2014

Medicine

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Sellar plasmacytoma is a rare cause of sellar lesions. Preoperative diagnosis remains a challenge.We present a 34-year-old Chinese woman with a 25-day history of headache and diplopia. A physical examination revealed incomplete left abducens nerve palsy.The initial diagnosis was invasive pituitary adenoma. The patient’s condition deteriorated suddenly the day before the arranged operating date, with the hemoglobin level declining from 113 to 70 g/L. The operation was cancelled and further studies confirmed the diagnosis of sellar solitary plasmacytoma that progressed to multiple myeloma. After undergoing radiotherapy, high-dose chemotherapy, and autologous peripheral blood stem cell transplantation, complete remission was achieved on 4 years follow-up.We reviewed the pertinent literature and reached the following conclusions: sellar plasmacytomas with development of multiple myeloma on follow-up more likely happened in men than in women; and if the sellar plasmacytoma does not compress the cranial nerve, transsphenoidal resection should be cautious because the systemic treatment with radiotherapy, chemotherapy, and autologous peripheral blood stem cell transplantation may be more effective with little invasion.

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“…Treatment for sellar plasmacytomas (either for local or residual disease) is most commonly radiotherapy and chemotherapy for systemic myelomatous disease 5 6 15–18. Case reviews in 20075 and a recent review6 on intrasellar plasmacytoma showed that majority of patients were diagnosed at pathology following transphenoidal resection.…”

Section: Discussionmentioning

confidence: 99%

“…Case reviews in 20075 and a recent review6 on intrasellar plasmacytoma showed that majority of patients were diagnosed at pathology following transphenoidal resection. Subsequent treatment regimens included radiotherapy (upto 80%) and chemotherapy (42%) of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Patients diagnosed initially with a solitary intrasellar plasmacytoma in the absence of occult disease showed a variable time frame to the development of systemic manifestations (0–22 months) 5 6. Over 50% will develop multiple myeloma within a decade and 10% develop a local recurrence of the plasmacytoma or another solitary plasmacytoma 20.…”

Section: Discussionmentioning

confidence: 99%

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Metastatic haematological malignancy presenting as a sellar mass

2012

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SummaryA man in his 60s with a history of multiple myeloma diagnosed 6 months previously was referred with a diagnosis of a sellar mass. He reported a 3-month history of headaches associated with double vision which appeared to improve with corticosteroid treatment. An MRI scan revealed a 3.7 cm×3 cm×2.6 cm sellar mass with erosion into the sphenoid sinus and extending to the right cavernous sinus. Pituitary function tests were normal apart from hypogonadotrophic hypogonadism. A diagnosis of plasmacytoma was considered and so transphenoidal biopsy of the sellar lesion was organised, which revealed sheets of mature appearing plasma cells, staining exclusively for κ-light chain immunoglobulins. He was to be started on chemotherapy for the myeloma and radiotherapy for the plasmacytoma. The patient's clinical course was complicated by community-acquired pneumonia and renal failure resulting in his death a month after the diagnosis of plasmacytoma. BACKGROUND

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Intrasellar plasmacytoma: An illustrative case and literature review

Cited by 12 publications

References 25 publications

Sellar and clival plasmacytomas: case series of 5 patients with systematic review of 65 published cases

Sellar and clival plasmacytomas: case series of 5 patients with systematic review of 65 published cases

Sellar Solitary Plasmacytoma Progressing to Multiple Myeloma

Metastatic haematological malignancy presenting as a sellar mass

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