Solitary plasmacytoma of the spine. Long-term clinical course

Abstract

The data for 19 patients with solitary plasmacytoma of the spine were reviewed with regard to clinical course and prognosis (median follow-up, 96 months). Eight patients presented with spinal cord compression. A monoclonal immunoglobulin was initially detected in seven of 15 evaluable patients. Treatment included radiotherapy (18 of 19) and/or surgery (11 of 19) and chemotherapy (eight of 19). Spinal cord compression was reversed in every patient. The expected survival rate was 85% at 10 years after diagnosis. Local recurrence or dissemination was observed in 13 patients. It occurred within 5 years of diagnosis in 11 patients and was localized (that is, local recurrence or single bone metastasis) in eight patients. It was always associated with the appearance or an increase of the M component. Dissemination frequently had a "metastatic" pattern with no diffuse bone marrow plasmacytosis. The incidence of local recurrence (five patients) and leukemia (four patients) was high. Local recurrence and/or dissemination were significantly more frequent in patients with the M component at diagnosis than in those without it (P less than 0.05; relative risk, R = 4). The effectiveness of surgery and chemotherapy combined with radiotherapy is also discussed.

A Review for Solitary Plasmacytoma of Bone and Extramedullary Plasmacytoma

“…Furthermore, it is suggested that early exposure to CHT may speed up the progression of resistant subclones and, therefore, limit later therapeutic options, when they may be more beneficial [1]. In addition, in one series, secondary leukemia developed in 4 of 7 patients with SBP who received adjuvant melphalan-based CHT after RT had been completed [56]. …”

Solitary plasmacytoma of the index finger

“…In all, 65% of cases occur in men with a median age of 55 years 8. The most common sites of osseous plasmacytoma are bones with active bone marrow haematopoiesis 10. An ‘M’ protein is found in serum or urine of an appreciable subset of patients 1 8 9…”

“…In addition, the location of the plasmacytoma in this patient is rare and resulted in some delays in establishing the correct diagnosis. Axial skeletal bones are most commonly involved and long bone involvement below the elbow or knee is rare 8 10. Although some reported cases of solitary osseous plasmacytoma have involved the extremities, to our knowledge there is only one reported case of a solitary plasma cell tumour involving the finger.…”

The Use of Zoledronic Acid for Solitary Osseous Plasmacytoma in a Dog

“…In humans, vertebral plasma cell tumors are divided into two types: multiple myeloma, which is the disseminated disease, and plasmacytoma, which is the rarer solitary plasma cell tumor 2) . A similar situation is reported in dogs and a solitary plasma cell tumor occurring in bone is known as a solitary osseous plasmacytoma (SOP) 18) .…”