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American Journal of Hematology Aug 2014Solitary plasmacytoma (SP) is a rare plasma cell dyscrasia characterized by the presence of bone or extramedullary plasma cell tumors. The treatment of choice is local...
Clinical features, outcome, and prognostic factors for survival and evolution to multiple myeloma of solitary plasmacytomas: a report of the Greek myeloma study group in 97 patients.
Solitary plasmacytoma (SP) is a rare plasma cell dyscrasia characterized by the presence of bone or extramedullary plasma cell tumors. The treatment of choice is local radiotherapy (R/T) ± surgical excision. The role of adjuvant chemotherapy (C/T) or novel agents (NA) is uncertain. Data related to prognostic factors are inconclusive. Herein, we describe the clinical features, survival and prognosis of 97 consecutive patients, 65 with bone SP (SBP), and 32 with extramedullary SP (SEP), diagnosed and treated in 12 Greek Myeloma Centers. Objective response rate (≥PR) and complete response (CR) was 91.8% and 61.9%, respectively, and did not differ between the 2 groups. Overall, 38 patients relapsed or progressed to multiple myeloma (MM). After a median follow-up of 60 months, 5 and 10-year overall survival (OS) probability was 92% and 89% in SEP and 86% and 69% in SBP, respectively (P = 0.2). The 5- and 10-year MM-free survival (MMFS) probability was 90% and 70% for patients with SEP vs. 59% and 50% for patients with SBP, respectively (P = 0.054). Overall, the 5- and 10-year OS probability, plasmacytoma relapse-free survival (PRFS), progression-free survival and MMFS was 84% and 78%, 72% and 58%, 58% and 43%, and 70% and 59%, respectively. In the multivariate analysis, prolonged PRFS and young age were positive predictors of OS. Achievement of CR was the only positive predictor of PRFS. Immunoparesis was the only negative predictor of progression to MM. The addition of C/T or NA-based treatment increased toxicity without offering any survival advantage over R/T.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anthracyclines; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Boronic Acids; Bortezomib; Chemotherapy, Adjuvant; Dexamethasone; Disease Progression; Female; Greece; Humans; Male; Melphalan; Middle Aged; Multiple Myeloma; Multivariate Analysis; Neoplasm Recurrence, Local; Plasmacytoma; Prognosis; Pyrazines; Remission Induction; Retrospective Studies; Survival Analysis; Treatment Outcome
PubMed: 24757085
DOI: 10.1002/ajh.23745 -
Journal of Hematology & Oncology Sep 2009Previous reports suggest an as yet unidentifiable subset of patients with plasmacytoma will progress to myeloma. The current study sought to establish the risk of...
BACKGROUND
Previous reports suggest an as yet unidentifiable subset of patients with plasmacytoma will progress to myeloma. The current study sought to establish the risk of developing myeloma and determine the prognostic factors affecting the progression of disease.
METHODS
Patients with plasmacytoma diagnosed between 1973 and 2005 were identified in the SEER database(1164 patients). Patient demographics and clinical characteristics, treatment(s), cause of death, and survival were extracted. Kaplan-Meier, log-rank, and Cox regression were used to analyze prognostic factors.
RESULTS
The five year survival among patients initially diagnosed with plasmacytoma that later progressed to multiple myeloma and those initially diagnosed with multiple myeloma were almost identical (25% and 23%; respectively). Five year survival for patients with plasmacytoma that did not progress to multiple myeloma was significantly better (72%). Age > 60 years was the only factor that correlated with progression of disease (p = 0.027).
DISCUSSION
Plasmacytoma consists of two cohorts of patients with different overall survival; those patients that do not progress to systemic disease and those that develop myeloma. Age > 60 years is associated with disease progression. Identifying patients with systemic disease early in the treatment will permit aggressive and novel treatment strategies to be implemented.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Bone Neoplasms; Child; Child, Preschool; Databases, Factual; Disease Progression; Humans; Infant; Infant, Newborn; Middle Aged; Orthopedics; Plasmacytoma; Radiotherapy; Retrospective Studies; SEER Program; Survival Analysis; Young Adult
PubMed: 19778427
DOI: 10.1186/1756-8722-2-41 -
Asian Journal of Surgery Jun 2023
Topics: Humans; Plasmacytoma; Skull; Bone Neoplasms
PubMed: 36610911
DOI: 10.1016/j.asjsur.2022.12.115 -
Journal of Cardiothoracic Surgery Oct 2015Solitary plasmacytoma of the bone, especially of a single rib, is a rare disease. We present the case of a 44-year-old Han Chinese man who was diagnosed with a solitary... (Review)
Review
Solitary plasmacytoma of the bone, especially of a single rib, is a rare disease. We present the case of a 44-year-old Han Chinese man who was diagnosed with a solitary plasmacytoma of the bone located in the right sixth rib. The patient presented with a 4-year history of continuous pain in the right chest area and moderate fever lasting 7 days. A chest roentgenogram showed a solitary expanding lesion in the right thorax, and chest computed tomography revealed an osteolytic tumor in the chest wall. The patient underwent complete en-bloc resection of the chest wall, including the ribs, muscle, and parietal pleura. Histologically, the resected mass was composed of abundant neoplastic plasma cells, and the diagnosis was confirmed to be a plasmacytoma of rib. The examination of marrow cells showed 9 % normal plasma cells among karyocytes without clonal disease. On postoperative day 14, the patient underwent thoracic radiotherapy with a total dose of 50 Gy. The patient remained asymptomatic during the 6-month follow-up period. Herein, we also review previous reports on solitary plasmacytomas of the rib. In summary, this report provides further insights for the diagnosis and effective treatment of this rare disease.
Topics: Adult; Bone Neoplasms; Combined Modality Therapy; Humans; Male; Plasmacytoma; Ribs; Thoracic Surgical Procedures; Treatment Outcome
PubMed: 26464186
DOI: 10.1186/s13019-015-0335-5 -
Diagnostic Pathology Sep 2015Nasopharyngeal carcinoma (NPC) is an EBV-associated malignant tumor of nasopharynx. As extremely rare condition, the second primary cancer of nasopharynx can occur in...
Nasopharyngeal carcinoma (NPC) is an EBV-associated malignant tumor of nasopharynx. As extremely rare condition, the second primary cancer of nasopharynx can occur in NPC patients synchronously or subsequently. Extramedullary plasmacytoma (EMP) is a rare tumor and commonly originates in the head and neck region. However, there is no report to describe a collision tumor of NPC and EMP occurring in the same nasopharyngeal mass. We report here an unusual case of synchronous coexistence of NPC and EMP occurring in the nasopharynx of an old male patient. A 63-year-old male patient presented with a 3-month history of right-sided nasal obstruction and recently intermittent epistaxis without enlargement of cervical lymph nodes. The solitary mass of nasopharynx was found by radiological and nasopharyngeal examination. Histologically, the mass contained two separated portions and displayed typically histological features of NPC and EMP, respectively. In EMP portion, the tumor was composed of monomorphic plasmacytoid-appearing cells with immuno-positive to CD79a, CD138, CD38, MUM-1 and CD56, but lack immunoreactivity to pan-CK (AE1/AE3), CD20, CD21 and EBERs. In NPC portion, the tumor cells formed irregular-shaped islands with diffusely immuno-positive to pan-CK (AE1/AE3), EMA and EBERs, but lack expressions of lymphoplasmacytic markers. A diagnosis of simultaneous occurrence of EMP and NPC in nasopharynx was made. There was no evidence of tumor recurrence or metastasis 18-month follow-up after radiotherapy. To our knowledge, it may be the first case of coexistence of EMP and NPC synchronously. In addition, the histological differential diagnosis and relevant potential mechanism of this unusual collision tumor were also discussed.
Topics: Biomarkers, Tumor; Carcinoma; Endoscopy; Epistaxis; Herpesvirus 4, Human; Humans; Immunohistochemistry; Magnetic Resonance Imaging; Male; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Neoplasms, Multiple Primary; Plasmacytoma; Treatment Outcome
PubMed: 26376733
DOI: 10.1186/s13000-015-0405-y -
Journal of the Formosan Medical... Apr 2023
Topics: Humans; Multiple Myeloma; Plasmacytoma; Stomach
PubMed: 36693771
DOI: 10.1016/j.jfma.2023.01.001 -
Journal of Medical Case Reports Feb 2015The gross majority of extramedullary plasmacytomas arise in the lymphatic tissue of the upper respiratory tract. On average, one third of patients with a solid...
INTRODUCTION
The gross majority of extramedullary plasmacytomas arise in the lymphatic tissue of the upper respiratory tract. On average, one third of patients with a solid plasmacytoma will develop multiple myeloma, resulting in a worse clinical outcome. We describe a case of rapid recurrent extramedullary plasmacytomas in the background of an asymptomatic multiple myeloma.
CASE PRESENTATION
A 71-year-old, white Caucasian woman presented with three extramedullary plasmacytomas occurring within a short time period. The third plasmacytoma was accompanied by progressive cervical pain and swallow dysfunction. Additional immunostaining test results were negative for CD56 and showed high MIB-1 expression in the extramedullary plasmacytoma and low MIB-1 expression in the bone marrow. A conventional swallow X-ray did not show any obstruction, however a magnetic resonance imaging scan of her cervical backbone revealed an extramedullary plasmacytoma, threatening her spinal cord. A short course of radiation therapy alleviated her pain and during almost a two-year follow-up period, the multiple myeloma remained asymptomatic, despite the rise in immunoglobulin A lambda levels. After the appearance of the third plasmacytoma, systemic chemotherapy was started to prevent the development of a fourth plasmacytoma, despite the asymptomatic character of the multiple myeloma.
CONCLUSIONS
In this case report we describe the rapid appearance of extramedullary plasmacytomas in the background of an asymptomatic multiple myeloma. An immunohistochemical analysis was negative for CD56 and showed high MIB-1 expression in the extramedullary plasmacytoma and low MIB-1 expression in the bone marrow, contributing to the potential underlying pathophysiology of the recurrent extramedullary plasmacytomas and their genetic changes. Systemic chemotherapy was started and no fourth extramedullary plasmacytoma has developed since.
Topics: Aged; Antineoplastic Agents; Combined Modality Therapy; Female; Humans; Immunosuppressive Agents; Magnetic Resonance Imaging; Melphalan; Multiple Myeloma; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Plasmacytoma; Prednisone
PubMed: 25880694
DOI: 10.1186/s13256-014-0506-3 -
Blood Mar 2003Angiogenesis plays an important role in the biology of multiple myeloma (MM) and has prognostic importance in this disease. Solitary plasmacytoma is a localized plasma...
Angiogenesis plays an important role in the biology of multiple myeloma (MM) and has prognostic importance in this disease. Solitary plasmacytoma is a localized plasma cell malignancy that progresses to MM in a significant number of patients. We examined if angiogenesis is increased in solitary plasmacytoma and if it can help identify patients likely to progress to myeloma. We studied angiogenesis in plasmacytoma biopsy samples and bone marrow biopsies from 25 patients. High-grade angiogenesis was present in 64% of plasmacytomas. In contrast, bone marrow angiogenesis was low in all patients. Patients with high-grade angiogenesis in the plasmacytoma sample were more likely to progress to myeloma and had a shorter progression-free survival compared with patients with low-grade angiogenesis (P =.02). Angiogenesis is increased in solitary plasmacytoma and is a significant predictor of progression to myeloma and provides further evidence of its importance in the pathogenesis of myeloma.
Topics: Adult; Aged; Aged, 80 and over; Biopsy; Bone Marrow; Bone Neoplasms; Disease Progression; Disease-Free Survival; Female; Follow-Up Studies; Humans; Life Tables; Male; Middle Aged; Multiple Myeloma; Myeloma Proteins; Neovascularization, Pathologic; Plasmacytoma; Prognosis; Proportional Hazards Models; Survival Analysis
PubMed: 12393501
DOI: 10.1182/blood-2002-08-2441 -
Journal of Integrative Neuroscience Jun 2021Plasmacytoma is a malignant tumor originating from the plasma cells of the bone marrow. Those discovered after a head injury is rare. We report a case of a 48-year-old...
Plasmacytoma is a malignant tumor originating from the plasma cells of the bone marrow. Those discovered after a head injury is rare. We report a case of a 48-year-old female who complained of scalp mass without other symptoms after head injury. Meningioma was considered preoperatively based on imaging findings, and surgical resection was performed. Postoperatively, multiple myeloma complicated by skull plasmacytoma was diagnosed by histopathology and systematic examinations in succession. When evaluating a head mass that appeared after a head injury, plasmacytoma should be considered at times. Osteolytic changes and biconvex form on imaging are beneficial to differentiation.
Topics: Craniocerebral Trauma; Female; Humans; Middle Aged; Multiple Myeloma; Plasmacytoma; Skull Neoplasms
PubMed: 34258947
DOI: 10.31083/j.jin2002048 -
American Journal of Hematology May 2010
Topics: Aged; Humans; Male; Plasmacytoma; Positron-Emission Tomography; Pulmonary Artery; Tomography, X-Ray Computed
PubMed: 20425805
DOI: 10.1002/ajh.21686