Plasmacytoma of the testis in a patient with previous multiple myeloma: sonographic appearance

Abstract

We present an unusual case of a 52-year-old man diagnosed with multiple myeloma 7 years ago, with osteolytic lesions of the cranium, vertebrae and pelvic bone. Treatment included radiation therapy, chemotherapy and bisphosphonates, followed by autologous stem-cell transplantation. After that, he was treated with maintenance immunotherapy to maintain disease remission. Three years ago, the patient presented with painless swelling of the left testicle. Ultrasonography revealed an enlarged inhomogeneous left testicle, with increased vascularity. After biopsy (a plasmacytoma was diagnosed) and failed radiotherapy, radical orchiectomy was performed. Six months ago, the patient had an initial increase in volume of the right testicle; ultrasonography showed a modest increase in testicular volume (approximately 4 cm) surrounded by an anechoic septated fluid collection diagnosed as hematocele. Four months ago, ultrasound showed a further increase in testicular volume (approximately 5 cm), with an unchanged fluid collection around the testicle. A further control after 2 months showed further volume increase (approximately 7 cm) of the testicle, which appeared inhomogeneous and hypervascularized (Figs.

Rare multifocal manifestation of solitary extramedullary plasmacytomas

“…Testicular SEP can have variable appearances on ultrasound, but as in our case, the most widely described sonographic appearance is that of a hyporeflective, heterogeneous mass with increased vascularity 12 13. However, there are cases of diffusely enlarge, heterogeneous testicles without a focal lesion 14 15. Similar to our case, the majority of the described pulmonary SEPs present as a solitary nodule or mass; however, reticulonodular opacities have also been described 16 17…”

Relapsed IgA Multiple Myeloma as Testicular Plasmacytoma after Quadrable Novel Therapy and Autologous Stem Cell Transplant: A Rare Case Report and Literature Review

“…Testicular EMD can occur synchronously with the primary MM diagnosis [14] or as an isolated testicular involvement in relapsed MM, as seen in our patient [15]. Ultrasound examination is often crucial for the diagnosis of MM [16], but a definitive diagnosis requires a tissue biopsy. To rule out other possible diagnoses, such as a germ cell tumor, an orchidectomy is usually performed.…”

Extramedullary plasmacytoma of the testis: A case report

“…US shows a heterogeneous low-echoic lesion with flow; however, the flow is reported to be low in comparison to other testicular tumors. 4 …”