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American Journal of Ophthalmology Case... Jun 2022Describe a case of intraocular plasmacytoma in a patient with multiple myeloma successfully treated with photon irradiation.
PURPOSE
Describe a case of intraocular plasmacytoma in a patient with multiple myeloma successfully treated with photon irradiation.
OBSERVATIONS
A 61-year-old man with a history of relapsing/refractory multiple myeloma and left frontal bone plasmacytoma treated with monthly belantamab mafodotin salvage chemotherapy developed bilateral treatment-related corneal keratopathy. An iris mass was incidentally noted in the right eye during a follow-up examination. The mass was amelanotic with diffuse intrinsic vasculature involving the pupillary margin from 1:30 to 10:30. Fundus examination showed an irregularly shaped amelanotic superotemporal scleral lesion in the right eye and two smaller amelanotic scleral lesions in the left eye. Given known systemic multiple myeloma and history of left frontal bone plasmacytoma, a presumed diagnosis of iris and scleral plasmacytoma was made. Due to rapid progression of the iris plasmacytoma despite systemic chemotherapy, the patient was treated with 20 Gy photon irradiation to the anterior and posterior segments of both eyes. One month after photon irradiation, there was complete regression of the iris plasmacytoma, and the scleral lesions in both eyes also appeared to be regressing despite systemic progression of multiple myeloma.
CONCLUSIONS AND IMPORTANCE
Intraocular plasmacytoma is rare and can occur in isolation but typically occurs as a manifestation of systemic multiple myeloma. Intraocular plasmacytoma can be successfully treated with photon irradiation in patients with multiple myeloma who progress on systemic chemotherapy.
PubMed: 35479520
DOI: 10.1016/j.ajoc.2022.101533 -
Cureus Jul 2022Pancreatic plasmacytoma is a rare entity of extramedullary plasmacytomas (EMP). It is important to consider pancreatic plasmacytoma in patients diagnosed with multiple...
Pancreatic plasmacytoma is a rare entity of extramedullary plasmacytomas (EMP). It is important to consider pancreatic plasmacytoma in patients diagnosed with multiple myeloma (MM) presenting with obstructive jaundice. We present a case of pancreatic plasmacytoma in a patient with previously diagnosed multiple myeloma and extramedullary plasmacytoma in remission. Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) were of great diagnostic and therapeutic value for acute management.
PubMed: 35923495
DOI: 10.7759/cureus.26502 -
Leukemia & Lymphoma Dec 2023Primary extraosseous plasmacytoma (PEP) is a rare and localized form of plasmacytoma that is not well understood. This study aimed to investigate the clinical features...
Primary extraosseous plasmacytoma (PEP) is a rare and localized form of plasmacytoma that is not well understood. This study aimed to investigate the clinical features and prognostic factors associated with PEP. Using the Surveillance, Epidemiology, and End Results (SEER) database, a total of 1044 patients diagnosed with PEP between 2000 and 2019 were identified. The average age was 60.3 ± 15.2 years, with 64.3% being male (male: female = 1.8:1) and 53.8% being over 60-year old. The survival outcome of patients with PEP depends on several factors including age, race, marital status, and treatment options such as chemotherapy, radiotherapy, and surgery, which were also identified as independent predictors of overall survival for PEP. Patients who were younger, Asian or Pacific Islander, American Indian or Native American, and received radiotherapy or surgery had a more favorable prognosis, while those who underwent chemotherapy had poorer outcomes.
Topics: Humans; Male; Female; Middle Aged; Aged; Plasmacytoma; Follow-Up Studies; SEER Program; Prognosis
PubMed: 37584346
DOI: 10.1080/10428194.2023.2245512 -
Frontiers in Endocrinology 2022Extramedullary plasmacytoma (EMP) can occur in various parts of the body. It is generally accepted that the highest site of occurrence is the head and neck region (80%...
RATIONALE
Extramedullary plasmacytoma (EMP) can occur in various parts of the body. It is generally accepted that the highest site of occurrence is the head and neck region (80% to 90%), followed by the gastrointestinal tract and the skin. It is worth mentioning that the site of disease, in this case, was the urethral meatus, which is extremely rare in clinical practice.
PATIENT CONCERNS
A 50-year-old female complained of an episode of painless gross hematuria without symptoms of frequent urination, urgency, abdominal pain, abdominal distension, fever, or oliguria. The patient has no history of smoking or drinking and denied any family history of solid malignancy or hematological disease.
DIAGNOSIS AND INTERVENTIONS
Urethrocystoscopy revealed urethral polypoid hyperplasia, which we initially thought could be a urethral caruncle. The patient was asked to undergo caruncle resection after 1 week of potassium permanganate sitz bath, and postoperative pathology revealed plasmacytoma. After that, a whole-body MRI showed no other lesions. She received postoperative radiotherapy.
OUTCOMES
During radiotherapy, the patient's condition and appetite were fair, and the skin mucositis was I°. Pelvic contrast-enhanced MRI and whole-body PET-CT 6 months after urethral meatus lumpectomy and radiotherapy showed changes without obvious abnormal signs. No recurrence or metastasis was detected after one year of follow-up.
LESSONS
Urinary EMP is a rare disease. It is not easy to diagnose due to its rare site of occurrence and non-specific symptoms. The diagnosis of EMP requires a combination of imaging studies and pathological findings. Currently, surgery combined with radiotherapy or radiotherapy alone is the mainstay treatment and usually results in an acceptable local control rate. At the same time, chemotherapy cannot be ignored.
Topics: Female; Humans; Magnetic Resonance Imaging; Middle Aged; Plasmacytoma; Positron Emission Tomography Computed Tomography
PubMed: 35250855
DOI: 10.3389/fendo.2022.783855 -
Cureus Jun 2022Orbital plasmacytomas are uncommon soft-tissue plasma cell neoplasms that are associated with a monoclonal or myeloma protein. There are four types of plasma cell...
Orbital plasmacytomas are uncommon soft-tissue plasma cell neoplasms that are associated with a monoclonal or myeloma protein. There are four types of plasma cell neoplasms: multiple myeloma (MM), monoclonal gammopathy of undetermined significance (MGUS), amyloidosis, and plasmacytoma. Plasmacytomas may be classified as medullary, occurring only within the bone, or extramedullary, occurring in soft tissues. Orbital plasmacytomas are extramedullary manifestations associated with MM and they may present with signs and symptoms such as unilateral proptosis, conjunctival injection, ocular pain, diplopia, and vision changes. The diagnosis of orbital plasmacytomas is based on tissue biopsy and histologic and immunohistochemical confirmation of a homogenous infiltrate of monoclonal plasma cells. In this report, we present a case of a 60-year-old female patient with a prior diagnosis of MM and new-onset bilateral orbital plasmacytomas following an autologous peripheral blood stem cell transplant; her condition improved significantly following treatment with dexamethasone, cisplatin, doxorubicin, cyclophosphamide, and etoposide along with palliative radiation therapy (RT) of 2000 cGy in 10 fractions to the orbits. Unfortunately, three months later, she had progression of extramedullary disease with parotid gland involvement. She had multiple complicated hospitalizations and eventually expired. As patients with orbital plasmacytomas classically have lower remission and survival rates compared to those with extramedullary plasmacytomas involving other locations, they must be considered high-risk patients who require a multidisciplinary approach for early diagnosis and timely treatment in order to prevent disease progression and to alleviate symptoms related to the disease.
PubMed: 35898379
DOI: 10.7759/cureus.26269 -
Joint Diseases and Related Surgery 2022The aim of this study was to examine the characterization of tumors and tumor-like lesions located in the clavicle and to present their clinical results.
OBJECTIVES
The aim of this study was to examine the characterization of tumors and tumor-like lesions located in the clavicle and to present their clinical results.
PATIENTS AND METHODS
Between January 2006 and December 2018, a total of 44 patients (25 males, 19 females; mean age: 36.2±21.8 years; range, 2 to 87 years) who were operated in our clinic for a clavicular lesion were included. Among 4,856 extremity tumors operated in our clinic between these years, 44 cases (0.9%) located in the clavicle were eligible. Demographic data, tumor types, location, surgical method, metastasis, survival analyzes and clinical results of these patients were reviewed retrospectively. According to the clavicle location, the patients were divided into groups according to their involvement in proximal, middle, lateral and more than one region.
RESULTS
The most frequently involved site was the lateral edge of the clavicle, and the most common tumor was aneurysmal bone cyst. The most common malignant tumor was Ewing sarcoma and plasmacytoma (13.6%) and the most common surgical method in the clavicle was wide resection with 34.1%. Of the 38 primary clavicle tumors remaining after the metastatic lesions were removed, 21 (55%) were benign, while 17 (45%) were malignant. Aneurysmal bone cyst was most common in the group under 30 years of age, osteochondroma was most common in the 30-50 age group, and plasmacytoma was most common in those over 50 years of age. The mean musculoskeletal tumor society (MSTS) score of 15 patients (34.1%) who underwent clavicle resection was 79.4±6.
CONCLUSION
We believe that a wide spectrum should be considered in the differential diagnosis of tumors located in the clavicle. Age is an important predictive factor for malignancy. We believe that resection should be applied without fear considering its effects on function and recurrence.
Topics: Adolescent; Adult; Bone Cysts, Aneurysmal; Bone Neoplasms; Clavicle; Female; Humans; Male; Middle Aged; Plasmacytoma; Retrospective Studies; Young Adult
PubMed: 35852207
DOI: 10.52312/jdrs.2022.669 -
Der Radiologe Jan 2022Treatment options for patients with solitary plasmacytoma (SP) or multiple myeloma (MM) should be discussed in an interdisciplinary context. This systematic review... (Review)
Review
BACKGROUND
Treatment options for patients with solitary plasmacytoma (SP) or multiple myeloma (MM) should be discussed in an interdisciplinary context. This systematic review focuses on the importance of radiotherapy in MM and SP.
OBJECTIVE
Summary of local radio-oncological treatment options for patients with SP and MM.
MATERIALS AND METHODS
Based on a systematic literature search, the current evidence on the topic was analyzed and summarized.
RESULTS
Patients with SP should be primarily treated with radiotherapy with or without surgery. Irradiation concepts may vary depending on risk factors and manifestation (solitary bone plasmacytoma vs. solitary extramedullary plasmacytoma). Although local control rates are high after radiotherapy, progression to multiple myeloma frequently occurs. In patients with MM, radiation is mainly used in palliative settings for pain relief, prevention of fractures or in patients who suffer from neurological symptoms due to spinal cord compression. Irradiation dose and fractionation should be selected based on treatment indication and general condition of the patient.
CONCLUSION
Although most patients receive systemic treatment at initial diagnosis, approximately 40% of patients with MM will require radiation during the course of their disease. While radiation is mainly used for palliation in patients with MM, it represents the primary and curative treatment option in patients with SP.
Topics: Bone Neoplasms; Humans; Multiple Myeloma; Plasmacytoma; Radiation Oncology; Risk Factors
PubMed: 34762165
DOI: 10.1007/s00117-021-00935-y -
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 -
Best Practice & Research. Clinical... Mar 2020Fluorine-18 (18F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) allows evaluation of elevated glucose metabolism in malignancies. There has been increasing... (Review)
Review
Fluorine-18 (18F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) allows evaluation of elevated glucose metabolism in malignancies. There has been increasing interest in FDG PET/CT for plasma cell disorders since the International Myeloma Working Group outlined multiple applications of this imaging modality, including distinguishing smoldering myeloma from active multiple myeloma, confirmation of solitary plasmacytoma, and multiple indications in patients with known multiple myeloma, including determining extent of initial disease, monitoring therapy response, and detection of residual disease following therapy. The field of molecular imaging is now shifting focus from evaluation of metabolism to targeted evaluation of specific tumor markers. Targeted PET imaging targeted of CXCR4 and CD38 has advanced into translational clinical trials, bringing us closer to powerful imaging options for myeloma. In this review we discuss the current applications of FDG PET/CT in plasma cell disorders, as well as advances in targeted PET imaging.
Topics: ADP-ribosyl Cyclase 1; B-Cell Maturation Antigen; Biomarkers, Tumor; Bone Marrow; Disease Progression; Fluorodeoxyglucose F18; Gene Expression; Humans; Membrane Glycoproteins; Neoplasm Proteins; Neoplasm, Residual; Plasma Cells; Plasmacytoma; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Receptors, CXCR4; Smoldering Multiple Myeloma
PubMed: 32139013
DOI: 10.1016/j.beha.2020.101148 -
Mayo Clinic Proceedings Jan 2024
Topics: Humans; Plasmacytoma; Larynx; Laryngeal Neoplasms
PubMed: 38176821
DOI: 10.1016/j.mayocp.2023.07.001