Solitary Plasmacytoma

Abstract

Solitary plasmacytoma is a rare disease characterized by a localized proliferation of neoplastic monoclonal plasma cells, without evidence of systemic disease. It can be subdivided into solitary bone plasmacytoma if the lesion originates in bone, or solitary extramedullary plasmacytoma if the lesion involves a soft tissue. The incidence of solitary bone plasmacytoma is higher than solitary extramedullary plasmacytoma. Also, the prognosis is different: even if both forms respond well to treatment, overall survival and progression-free survival of solitary bone plasmacytoma are poorer than solitary extramedullary plasmacytoma due to its higher rate of evolution in multiple myeloma. However, the recent advances in the diagnosis of multiple myeloma can better refine also the diagnosis of plasmacytoma. Flow cytometry studies and molecular analysis may reveal clonal plasma cells in the bone marrow; magnetic resonance imaging or 18 Fluorodeoxyglucose positron emission tomography could better define osteolytic bone lesions. A more explicit exclusion of possible occult systemic involvement can avoid cases of misdiagnosed multiple myeloma patients, which were previously considered solitary plasmacytoma and less treated, with an unavoidable poor prognosis.Due to the rarity of the disease, there is no uniform consensus about prognostic factors and treatment. Radiotherapy is the treatment of choice; however, some authors debate about the radiotherapy dose and the relationship with the response rate. Moreover, the role of surgery and chemotherapy is still under debate. Nevertheless, we must consider that the majority of studies include a small number of patients and analyze the efficacy of conventional chemotherapy; few cases are reported concerning the efficacy of novel agents.

Solitary bone plasmacytoma compression injury disguised as back pain: a case report

“…The average age of patients diagnosed with SP is 55-60 years old [3]. The incidence of SP in males is significantly higher than the incidence in females [6].…”

“…This case report discusses a patient who initially presented with low back pain, which eventually was determined to be caused by a solitary bone plasmacytoma (SBP). Solitary plasmacytoma (SP) is a rare type of plasma cell dyscrasia [3]. In this case, an even rarer phenomenon is presented: spinal cord compression due to plasma cell infiltration.…”

Temporal bone neoplasia: a rare entity

“…There are two rare important variants of myeloma—solitary bone plasmacytoma (SBP), when it arises in an intraosseus location, which was what happened in our clinical case; and solitary extramedullary plasmacytoma (SEP), when it arises within the soft tissue 1. Both are associated with a survival of ≥10 years,1 accounting for approximately 2–5% of all PC disorders2 3 and are characterised by a localised proliferation of neoplastic monoclonal PCs, with no radiological evidence of additional skeletal lesions, absence of signs and symptoms of multiple myeloma (hypercalcaemia, renal insufficiency, anaemia and/or bone lesions) and a normal bone marrow examination or having less than 10% clonal PC infiltration 2. More than 80% of solitary plasmacytomas show up in head and neck area 3.…”

Potential of oncolytic viruses in the treatment of multiple myeloma

“… 5 , 6 Eventually, disease progresses to symptomatic MM, in which malignant cells proliferate rapidly in the bone marrow, causing localized sites of malignancy known as plasmacytomas. While a few patients present with single plasmacytomas, 7 most develop a systemic disease characterized by multiple distinct tumors, hence the name “multiple myeloma”. Malignant cells in these lesions secrete a variety of factors that cause remodeling of local bone structure, resulting in osteolytic lesions.…”