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Current Medical Imaging 2023The study aimed to analyze computed tomography and magnetic resonance imaging features of patients with solitary extramedullary plasmacytoma. (Review)
Review
OBJECTIVE
The study aimed to analyze computed tomography and magnetic resonance imaging features of patients with solitary extramedullary plasmacytoma.
METHODS
Ten cases with solitary extramedullary plasmacytoma were included in this study. CT and MRI features of solitary extramedullary plasmacytoma were retrospectively analyzed.
RESULTS
This study included both males (n = 8) and females (n = 2), with a median age of 48 (range 21-72 years old). The organs or anatomical structures involved were nasopharynx (n = 3), orbit (n = 1), left tentorium (n = 1), nasal cavity and meatus (n = 2), small intestine and mesentery (n = 1), as well as posterior thoracic wall (n = 2). The median maximum diameter of the tumors was 3.2 cm (range 0.8- 15.2 cm). The tumor shapes were round (n = 7), stripped (n = 1), irregular (n = 1), and nodular (n = 1). The margin of the tumors was well-defined (n = 7) and partially well-defined (n = 3). There were 3 cases with bone destruction and 1 with a tissue invasion adjacent to the tumor, calcification (n = 1), and cystic degeneration (n = 2). Enlarged tumoral vessels (n = 4) could also be observed. The CT attenuation and MR signal intensity of tumors were heterogeneous (n = 4) and homogenous (n = 6). After the injection of the contrast agent, marked (n = 5), mild (n = 1), mild to moderate (n = 1), and delayed enhancement (n = 1) could be observed.
CONCLUSION
A well-defined homogeneous solitary mass occurring at the head and neck with a marked enhancement, an adjacent tissue invasion, enlarged tumoral vessels, and bone destruction can indicate the diagnosis of solitary extramedullary plasmacytoma.
Topics: Male; Female; Humans; Young Adult; Adult; Middle Aged; Aged; Plasmacytoma; Retrospective Studies; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Bone Neoplasms
PubMed: 36788682
DOI: 10.2174/1573405619666230213114231 -
Mayo Clinic Proceedings Jan 2024
Topics: Humans; Plasmacytoma; Larynx; Laryngeal Neoplasms
PubMed: 38176821
DOI: 10.1016/j.mayocp.2023.07.001 -
Medicine Jun 2023Plasmacytoma is a disease caused by the proliferation of monoclonal immunoglobulin-producing plasma cells and divided into multiple myeloma, solitary bone plasmacytoma,...
RATIONALE
Plasmacytoma is a disease caused by the proliferation of monoclonal immunoglobulin-producing plasma cells and divided into multiple myeloma, solitary bone plasmacytoma, and extramedullary plasmacytoma. We report a case of orbital extramedullary plasmacytoma invading the dura mater in a patient with exophthalmos and diplopia.
PATIENT CONCERNS
A 35-year-old female patient with exophthalmos in the right eye and diplopia visited the clinic.
DIAGNOSES
The thyroid function tests showed nonspecific results. Orbital computed tomography and magnetic resonance imaging revealed a homogeneously enhancing orbital mass infiltrating the right maxillary sinus and adjacent brain tissue in the middle cranial fossa through the superior orbital fissure.
INTERVENTIONS
To diagnose and alleviate the symptoms, an excisional biopsy was performed, which revealed a plasmacytoma.
OUTCOMES
One month after the surgery, the protruding symptoms and eye movement restriction in the right eye improved, and the visual acuity in the right eye was restored.
LESSONS
In this case report, we present a case of an extramedullary plasmacytoma that originated in the inferior wall of the orbit and invaded the cranial cavity. To our knowledge, no previous reports have described a solitary plasmacytoma that originated in the orbit, causing exophthalmos and invading the cranial cavity at the same time.
Topics: Female; Humans; Adult; Plasmacytoma; Orbit; Diplopia; Orbital Neoplasms; Exophthalmos
PubMed: 37327309
DOI: 10.1097/MD.0000000000033920 -
Clinical Nuclear Medicine Dec 2022Myeloma involving the laryngeal cartilage is rare, whereas extramedullary plasmacytoma involving only the thyroid cartilage is even rarer. No case of de novo...
Myeloma involving the laryngeal cartilage is rare, whereas extramedullary plasmacytoma involving only the thyroid cartilage is even rarer. No case of de novo extramedullary plasmacytoma involving thyroid cartilage has been published so far. Hence, it was a diagnostic challenge for clinicians, radiologists, and pathologists. Here, we presented a case of a 61-year-old man who had fixed right laryngeal swelling. After 18 F-FDG PET/CT, biopsy, and myeloma workup, it was found to be plasmacytoma involving the right thyroid cartilage lamina. This case highlighted the rarity of this presentation and the importance of keeping in mind this differential to lead toward diagnosis.
Topics: Male; Humans; Middle Aged; Plasmacytoma; Thyroid Cartilage; Multiple Myeloma; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Spinal Fractures
PubMed: 36083208
DOI: 10.1097/RLU.0000000000004403 -
Clinical Gastroenterology and... Jul 2020
Topics: Abdomen; Humans; Plasmacytoma; Stomach Neoplasms
PubMed: 31042583
DOI: 10.1016/j.cgh.2019.04.050 -
Clinical Lymphoma, Myeloma & Leukemia Dec 2016Multiple myeloma/plasmacytoma-like posttransplantation lymphoproliferative disorder (PTLD-MM) is a rare complication of solid organ transplantation. Case series have...
BACKGROUND
Multiple myeloma/plasmacytoma-like posttransplantation lymphoproliferative disorder (PTLD-MM) is a rare complication of solid organ transplantation. Case series have shown variable outcomes, and survival data in the modern era are lacking.
PATIENTS AND METHODS
A cohort of 212 PTLD-MM patients was identified in the Scientific Registry of Transplant Recipients between 1999 and 2011. Overall survival (OS) was estimated by the Kaplan-Meier method, and the effects of treatment and patient characteristics on OS were evaluated by Cox proportional hazards models. OS in 185 PTLD-MM patients was compared to 4048 matched controls with multiple myeloma (SEER-MM) derived from Surveillance, Epidemiology, and End Results (SEER) data.
RESULTS
Men comprised 71% of patients; extramedullary disease was noted in 58%. Novel therapeutic agents were used in 19% of patients (more commonly during 2007-2011 vs. 1999-2006; P = .01), reduced immunosuppression in 55%, and chemotherapy in 32%. Median OS was 2.4 years and improved in the later time period (adjusted hazard ratio [aHR], 0.64, P = .05). Advanced age, creatinine > 2 g/dL, white race, and use of OKT3 were associated with inferior OS in multivariable analysis. OS of PTLD-MM patients is significantly inferior to SEER-MM patients (aHR, 1.6, P < .001). Improvements in OS over time differed between PTLD-MM and SEER-MM. Median OS of patients diagnosed from 2000 to 2005 was shorter for PTLD-MM than SEER-MM patients (18 vs. 47 months, P < .001). There was no difference among those diagnosed from 2006 to 2010 (44 months vs. median not reached, P = .5; interaction P = .08).
CONCLUSION
Age at diagnosis, elevated creatinine, white race, and OKT3 were associated with inferior survival in patients with PTLD-MM. Survival of PTLD-MM is inferior to SEER-MM, although significant improvements in survival have been documented.
Topics: Aged; Female; Humans; Immunosuppression Therapy; Kaplan-Meier Estimate; Lymphoproliferative Disorders; Male; Middle Aged; Multiple Myeloma; Organ Transplantation; Plasmacytoma; Prognosis; Proportional Hazards Models; Risk Factors; SEER Program; Survival Analysis; United States
PubMed: 27771291
DOI: 10.1016/j.clml.2016.09.002 -
American Journal of Rhinology & Allergy Sep 2022While extramedullary plasmacytomas are infrequently encountered plasma cell malignancies, most cases occur in the head and neck, with a predilection for the sinonasal...
BACKGROUND
While extramedullary plasmacytomas are infrequently encountered plasma cell malignancies, most cases occur in the head and neck, with a predilection for the sinonasal cavity. Due to the rarity of this disease, the majority of studies on sinonasal extramedullary plasmacytoma (SN-EMP) are case reports or small retrospective case series.
OBJECTIVE
To investigate the impact of patient, disease, and treatment factors on the survival of patients with SN-EMP.
METHODS
The National Cancer Database was queried for all patients with SN-EMP between 2004-2016 (N = 381 cases). Univariate and multivariate analyses were used to examine patient demographics, tumor characteristics, and survival.
RESULTS
The majority of SN-EMP patients were over 60 years old (57.0%), male (69.8%), and white (86.2%). The most common treatment modality was radiotherapy alone (38.6%), followed by surgery plus radiotherapy (37.8%). Five-year overall survival was 74.0% and median survival was 9.1 years. Accounting for patient demographics and tumor characteristics in a multivariate model, the following groups had worse prognosis: 60 and older (HR 1.99, p = 0.031) and frontal sinus primary site (HR 11.56, p = 0.001). Patients who received no treatment (HR 3.89, p = 0.013), chemotherapy alone (HR 5.57, p = 0.008) or radiotherapy plus chemotherapy (HR 2.82, p = 0.005) had significantly lower survival than patients who received radiotherapy alone. Patients who received surgery with radiotherapy (HR 0.57, p = 0.039) had significantly higher survival than patients who received radiotherapy alone.
CONCLUSION
In patients with SN-EMP five-year overall survival was found to be 74.0% with decreased survival associated with a frontal sinus primary site and being aged 60 or older. Patients receiving no treatment, chemotherapy alone, or radiotherapy with chemotherapy was associated with lower survival. Receiving surgery plus radiotherapy was associated with the highest five-year overall survival.
Topics: Combined Modality Therapy; Humans; Male; Middle Aged; Paranasal Sinus Neoplasms; Plasma Cells; Plasmacytoma; Retrospective Studies; Survival Analysis
PubMed: 35440217
DOI: 10.1177/19458924221092529 -
HNO Nov 2015
Topics: Aged; Diagnosis, Differential; Female; Humans; Mouth Mucosa; Mouth Neoplasms; Pain, Postoperative; Plasmacytoma; Tooth Extraction; Treatment Outcome
PubMed: 26854305
DOI: 10.1007/s00106-015-0057-y -
Future Oncology (London, England) Jul 2021
Topics: Bone Neoplasms; Combined Modality Therapy; Humans; Jaw Neoplasms; Plasmacytoma
PubMed: 34047196
DOI: 10.2217/fon-2021-0316 -
World Neurosurgery Feb 2020Most plasmacytomas arise in the bone marrow (intramedullary), as part of multiple myeloma (MM). In contrast, extramedullary plasmacytoma without MM is rare, and... (Review)
Review
BACKGROUND
Most plasmacytomas arise in the bone marrow (intramedullary), as part of multiple myeloma (MM). In contrast, extramedullary plasmacytoma without MM is rare, and plasmacytoma primarily occurring in the brain parenchyma is extremely rare. Clinical behaviors of primary plasmacytoma in the brain have remained unclear. We report a case of primary plasmacytoma in the cerebellum and review the literature.
CASE DESCRIPTION
The patient was a 33-year-old woman, displaying vertigo and peripheral facial nerve palsy. A tumor was identified in the subcortical white matter of the middle-upper cerebellum. Magnetic resonance imaging showed no specific findings for this lesion. Tumor was surgically resected because of aggressive tumor growth. Pathologic diagnosis of the tumor was plasmacytoma. The patient was treated with irradiation to the tumor bed after surgery. Although histology of the bone marrow showed a few atypical plasma cells (1%-2%), below the threshold of the diagnostic criterion for MM, we started chemotherapy to prevent occurrence of MM. Neither tumor recurrence nor development of MM was found for 16 months after surgery.
CONCLUSIONS
Histology is essential for diagnosis of primary plasmacytoma in the brain because of the lack of specific findings on neuroimaging. A finding of a few atypical plasma cells in the bone marrow might support the assumption that extramedullary plasmacytoma represents a harbinger of subsequent development of MM. In addition to appropriate therapies combining maximum tumor removal and radiotherapy to the brain, rigorous hematological management might have contributed to favorable outcomes.
Topics: Adult; Antineoplastic Agents; Bortezomib; Cerebellar Neoplasms; Chemotherapy, Adjuvant; Facial Nerve Diseases; Female; Humans; Magnetic Resonance Imaging; Maintenance Chemotherapy; Neurosurgical Procedures; Plasmacytoma; Radiotherapy; Vertigo
PubMed: 31629133
DOI: 10.1016/j.wneu.2019.10.036