Radiation response of soft‐tissue extramedullary plasmacytoma in multiple myeloma—A case report

Gaube, Alexandra; Nica, Silvia; Dobrea, Camelia; Neicu, Stefania Ariana; Moldoveanu, Vanessa; Serbanescu, Magda; Calangiu, Filip

doi:10.1002/ccr3.5084

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…According to the literature, RT is typically administered over a 4-week period with a total dose ranging from 40 to 50 Gy ( 29 ). In the majority of EMP cases, radiotherapy is effective, demonstrating excellent disease control and a low risk of recurrence ( 30 ). Given the radiosensitive nature of EMP, RTH remains the treatment of choice.…”

Section: Discussionmentioning

confidence: 99%

Case report: An uncommon presentation of extramedullary plasmacytoma without a concurrent diagnosis of multiple myeloma

Stawarz,

Galazka,

Gorzelnik

et al. 2024

Front. Oncol.

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IntroductionExtramedullary plasmacytoma (EMP) is an uncommon solitary tumor originating from neoplastic plasma cells located outside the bone marrow. Despite its rarity, the occurrence of EMP without a concurrent diagnosis of multiple myeloma (MM) is considered extremely rare. Approximately 80–90% of EMP cases are found in the head and neck region, with a higher incidence in men aged between 50 and 60 years. The current treatment modalities include radiotherapy (RT) as a first-line approach, with surgery or chemotherapy regarded as other therapeutic options. While RT proves effective in the majority of EMP cases, there are instances where the tumor remains refractory to radiation. In this case report, we present an unusual scenario of EMP resistant to RT without concurrent signs of multiple myeloma which was successfully treated with surgery followed by systemic therapy.Case reportA 72-year-old male was admitted to the Head and Neck Cancer Clinic with a 6-month history of swallowing difficulties. He denied experiencing weight loss or pain on swallowing. Basic laboratory tests yielded results within normal limits, except for beta-2 microglobulin. Physical examination revealed an enlarged submandibular lymph node on the right side. Fiberoptic examination identified a soft tissue polypoid mass within the right piriform fossa, slightly protruding into the vocal slit. A CT scan displayed a well-circumscribed 2 cm polypoid, homogeneously enhancing soft tissue mass adjacent to the posterior surface of the epiglottis and the right side of the tongue base. Bone marrow biopsy revealed no abnormalities, and there were no clinical or laboratory signs of multiple myeloma. Based on the tumor biopsy results and imaging studies, a diagnosis of EMP was made. Due to the lack of response to RT, surgical removal of the tumor was pursued, followed by systemic therapy. Ultimately, the patient achieved full recovery with effective disease control.ConclusionIn conclusion, EMP without concurrent multiple myeloma is an exceedingly rare condition that demands a multidisciplinary approach for both diagnosis and treatment. Moreover, although RT continues to be the primary standard treatment for EMP, in some cases other therapeutic regimens prove to be successful.

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Section: Discussionmentioning

confidence: 99%

Case report: An uncommon presentation of extramedullary plasmacytoma without a concurrent diagnosis of multiple myeloma

Stawarz,

Galazka,

Gorzelnik

et al. 2024

Front. Oncol.

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“…При ММ лучевая терапия применяется преимущественно на область костных плазмоцитом после системной химиотерапии [68]. Опубликованные данные посвящены преимущественно выполнению ЛЛТ в качестве паллиативной меры, позволяющей облегчить состояние пациента и купировать болевой Костные плазмоцитомы при ММ синдром при сдавлении спинного мозга и нервных стволов, избежать патологических переломов при внутрикостных плазмоцитомах с разрушением коркового слоя [69,70]. На фоне ЛЛТ отмечается уменьшение размера плазмоцитом, а в ряде случаев -с развитием патоморфоза опухоли [71].…”

Section: клиническая онкогематологияunclassified

Multiple Myeloma Complicated by Bone Plasmacytomas: Pathogenesis, Clinical Features, Treatment Approaches (A Literature Review)

Мамаева,

Соловьева,

Менделеева

2024

Clinical Oncohematology

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Bone plasmacytoma is a malignant neoplasm consisting of plasma cells. It develops in the medullary cavities of the skeletal bones. The tumor can destroy bone cortex and proliferate into the surrounding tissues. In contrast to bone plasmacytomas, extramedullary plasmacytomas occur as a result of hematogenous dissemination in various tissues and organs. Based on literature data, the incidence of bone plasmacytomas at multiple myeloma (MM) onset is 7.0 % to 32.5 %, and at relapsed/progression ММ stages it is 9.0 % to 27.4 %. During bone plasmacytoma development, tumor cells acquire a number of new features: expression of adhesion molecules is decreased, new cytogenetic aberrations occur, autocrine secretion and neoangiogenesis are increased. The clinical course of MM complicated by bone plasmacytomas is characterized by minimal bone marrow damage, hemoglobin concentration within reference range, and decreased values of β2-microglobulin, paraprotein, calcium, and lactate dehydrogenase. Acute renal failure and immunoparesis are rare, early MM stages predominate. In literature, the MM form with multiple bone plasmacytomas is referred to as ‘macrofocal MM’. Survival rates of MM patients with bone plasmacytomas are at the intermediate level in terms of prognosis. The MM patients without plasmacytomas have the most favorable prognosis, whereas the MM patients with extramedullary plasmacytomas have the poorest prognosis. There is no unified approach to the treatment of MM complicated by bone plasmacytomas. There are no randomized prospective clinical studies on the efficacy of treating it. A successful use of proteasome inhibitors and immunomodulatory drugs was reported based on a small number of MM cases with plasmacytomas. Some studies proved the efficacy of auto-HSCT in this MM form. Bone plasmacytomas are treated with radiotherapy mainly after systemic chemotherapy.

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Radiation response of soft‐tissue extramedullary plasmacytoma in multiple myeloma—A case report

Cited by 2 publications

References 18 publications

Case report: An uncommon presentation of extramedullary plasmacytoma without a concurrent diagnosis of multiple myeloma

Case report: An uncommon presentation of extramedullary plasmacytoma without a concurrent diagnosis of multiple myeloma

Multiple Myeloma Complicated by Bone Plasmacytomas: Pathogenesis, Clinical Features, Treatment Approaches (A Literature Review)

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