scholarly journals Solitary Extramedullary Plasmacytoma of the Maxillary Sinus, Progressing to Smoldering Multiple Myeloma with Multifocal Skeletal Involvement, which Resolved Completely Following Chemotherapy Alone

2015 ◽  
Vol 15 (S2) ◽  
pp. 229-239 ◽  
Author(s):  
Priya Jeyaraj ◽  
Manu Venkatesan ◽  
V. S. Nijhawan
Keyword(s):  
Multiple Myeloma ◽  
Maxillary Sinus ◽  
Extramedullary Plasmacytoma ◽  
Skeletal Involvement ◽  
Smoldering Multiple Myeloma ◽  
Solitary Extramedullary Plasmacytoma

Primary Plasmacytoma of the Breast

2001 ◽  
Vol 125 (8) ◽  
pp. 1078-1080 ◽  
Author(s):  
Annarosaria De Chiara ◽  
Simona Losito ◽  
Luigi Terracciano ◽  
Raimondo Di Giacomo ◽  
Giancarla Iaccarino ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Extramedullary Plasmacytoma ◽  
Frozen Sections ◽  
Solitary Extramedullary Plasmacytoma ◽  
Extramedullary Plasmacytomas

Abstract We describe a solitary extramedullary plasmacytoma of the breast in a 37-year-old woman. No other involvement was detected in the bone marrow or in any other site during a 15-month follow-up period. Extramedullary plasmacytomas of the breast are extremely rare, especially those that are not associated with multiple myeloma. We review the histologic features of the previously reported cases with an emphasis on differential diagnosis and the difficulties encountered in arriving at the correct diagnosis in frozen sections.

Prognostic Factors for Malignant Transformation in Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple Myeloma

2002 ◽  
Vol 20 (6) ◽  
pp. 1625-1634 ◽  
Author(s):  
Clara Cesana ◽  
Catherine Klersy ◽  
Luciana Barbarano ◽  
Anna Maria Nosari ◽  
Monica Crugnola ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Monoclonal Gammopathy ◽  
Extramedullary Plasmacytoma ◽  
Lymphocytic Leukemia ◽  
Cumulative Probability ◽  
Primary Amyloidosis ◽  
Smoldering Multiple Myeloma ◽  
Bence Jones Proteinuria ◽  
Undetermined Significance

PURPOSE: To evaluate the natural history of monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM), identify early predictors of evolution, and assess whether associated conditions correlate with disease progression. PATIENTS AND METHODS: A total of 1,231 consecutive patients with either MGUS (n = 1,104) or SMM (n = 127) diagnosed from July 1975 to March 1998 were included in the study. Cumulative survival probability and cumulative probability of transformation into lymphoproliferative disease were calculated by means of the Kaplan-Meier estimator. Univariate and multivariate Cox models were used to identify possible predictors of malignant evolution. RESULTS: Cumulative transformation probability at 10 and 15 years was 14% and 30%, respectively. At a median follow-up of 65 months (range, 12 to 239 months), 64 MGUS cases (5.8%) evolved to multiple myeloma (MM) (n = 43), extramedullary plasmacytoma (n = 1), primary amyloidosis (n = 1), Waldenström’s macroglobulinemia (n = 12), non-Hodgkin’s lymphoma (n = 6), and B-chronic lymphocytic leukemia (n = 1). At a median follow-up of 72 months (range, 12 to 247 months), 25 SMMs (19.7%) evolved to overt MM. A lower evolution risk was observed in MGUS than in SMM (P < .0001). Greater than 5% marrow plasmacytosis, detectable Bence Jones proteinuria, polyclonal serum immunoglobulin reduction, and high erythrocyte sedimentation rate (ESR) were independent factors influencing MGUS transformation. SMM progression correlated with greater than 10% marrow plasma cells, detectable Bence Jones proteinuria, and immunoglobulin (Ig) A isotype. Neither concomitant diseases nor immunosuppression correlated with progression. CONCLUSION: Careful evaluation of marrow plasmacytosis, urinary paraprotein, background immunoglobulins, ESR, and paraprotein isotype might help identify at presentation patients with benign monoclonal gammopathies requiring stricter monitoring.

scholarly journals Intraocular solitary extramedullary plasmacytoma presenting as unilateral anterior and intermediate uveitis preceded by refractory glaucoma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tom Ayton ◽  
Svetlana Cherepanoff ◽  
David Gottlieb ◽  
William A. Sewell ◽  
Sandy Smith ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
External Beam Radiotherapy ◽  
Bone Marrow Involvement ◽  
Extramedullary Plasmacytoma ◽  
Intraocular Inflammation ◽  
Refractory Glaucoma ◽  
Uveal Tract ◽  
First Case ◽  
Solitary Extramedullary Plasmacytoma

Abstract Background Solitary extramedullary plasmacytoma (SEP) is a localised proliferation of monoclonal plasma cells involving soft tissue with no or minimal bone marrow involvement and no other systemic evidence of multiple myeloma. Intraocular involvement is exceedingly rare. Case presentation We report a 78-year-old man who was referred with glaucoma in the right eye. He subsequently developed anterior chamber (AC) inflammation and refractory glaucoma then dense vitritis. A vitrectomy was performed with the biopsy revealing numerous plasma cells with atypical findings. In conjunction with the flow cytometry results, and a systemic work up excluding multiple myeloma, a diagnosis of SEP was made. The patient was treated with ocular external beam radiotherapy with resolution of the intraocular inflammation and control of the intraocular pressure. He remains well with no local recurrence and no development of multiple myeloma over a follow up period of 2.5 years. Conclusions This is the first case report of SEP presenting as intraocular inflammation without a uveal tract mass.

scholarly journals SOLITARY PLASMACYTOMA

2017 ◽  
Vol 9 (1) ◽  
pp. e2017052 ◽  
Author(s):  
Sara Grammatico ◽  
Emilia Scalzulli ◽  
Maria Teresa Petrucci
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Systemic Disease ◽  
Extramedullary Plasmacytoma ◽  
Bone Lesions ◽  
Solitary Plasmacytoma ◽  
Systemic Involvement ◽  
Number Of Patients ◽  
Solitary Bone Plasmacytoma ◽  
Solitary Extramedullary Plasmacytoma

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. Incidence of solitary bone plasmacytoma is higher than solitary extramedullary plasmacytoma. Also prognosis is different: even if both forms respond well to treatment, overall survival and progression free survival of solitary bone plasmacytoma is 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 precise exclusion of eventual occult systemic involvement can avoid cases of misdiagnosed multiple myeloma patients, that 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 debates 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.Keywords: solitary plasmacytoma; myeloma; radiotherapy; osteolytic lesions  

scholarly journals Solitary Extramedullary Plasmacytoma of the Thyroid Gland

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
M. Ridal ◽  
N. Ouattassi ◽  
T. Harmouch ◽  
A. Amarti ◽  
M. N. Alami
Keyword(s):  
Multiple Myeloma ◽  
Thyroid Gland ◽  
Lymph Nodes ◽  
Extramedullary Plasmacytoma ◽  
Pathological Features ◽  
Combined Approach ◽  
First Case ◽  
Uncommon Condition ◽  
Solitary Extramedullary Plasmacytoma ◽  
Rule Out

Solitary extramedullary plasmacytoma of the thyroid gland is an uncommon condition. Up to date, its clinical pathological features are not fully understood. We present a case of an extramedullary nonmucosal plasmacytoma of the thyroid gland which is the first case with regional metastatic lymph nodes. This condition requires a scrupulous survey to rule out a metastatic multiple myeloma. Although localized forms management is still controversial, authors require combined approach for regional metastatic forms. The prognosis is favorable compared to solitary bone plasmacytomas or multiple myeloma.

scholarly journals Extramedullary Plasmacytoma in the Maxillary Sinus

2009 ◽  
Vol 24 (2) ◽  
pp. 27-31
Author(s):  
Jennifer De Silva-Leonardo ◽  
Rosario R. Bito-Ricalde ◽  
Jose Roberto V. Claridad ◽  
Erasmo Gonzalo DV. Llanes
Keyword(s):  
Multiple Myeloma ◽  
Maxillary Sinus ◽  
Plasma Cell ◽  
Systemic Disease ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Extramedullary Plasmacytoma ◽  
Complete Excision ◽  
Left Maxillary Sinus ◽  
High Index Of Suspicion

Objective: To describe an intranasal mass initially diagnosed and treated as benign, that eventually turned out to be a malignant extramedullary plasmacytoma of the maxillary sinus, and to review the literature on its presenting signs and symptoms, diagnosis, management and pathophysiology. Methods: Design: Case Report  Setting: Tertiary Public Hospital Patient: One Results: A 45-year-old male with persistent nasal obstruction and intermittent epistaxis underwent several biopsies of a mass shown on computed tomography scans as heterogeneously enhancing, expansile, occupying the left maxillary sinus with extension into the left nasal cavity with areas of erosion.  Immunohistochemical staining was negative for cytokeratin (CK) and leukocyte common antigen (LCA). Complete excision yielded a final histopathologic interpretation of plasmacytoma. Laboratory examinations excluded multiple myeloma. The final diagnosis was extramedullary plasmacytoma and he was treated with post-operative adjuvant radiotherapy.  Conclusion:  Plasmacytoma may present in the sinu-nasal region and be part of a systemic disease like multiple myeloma. A high index of suspicion and thorough initial histopathological work-up may help in establishing a definitive diagnosis and providing optimum treatment. Keywords: Plasmacytoma, plasma cell tumor, multiple myeloma, plasma cell myeloma, extramedullary plasmacytoma

scholarly journals What Is New in the Treatment of Smoldering Multiple Myeloma?

2021 ◽  
Vol 10 (3) ◽  
pp. 421
Author(s):  
Niccolo’ Bolli ◽  
Nicola Sgherza ◽  
Paola Curci ◽  
Rita Rizzi ◽  
Vanda Strafella ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Clinical Trials ◽  
High Risk ◽  
Early Treatment ◽  
Individual Case ◽  
Symptomatic Disease ◽  
Plasma Cell Neoplasm ◽  
Smoldering Multiple Myeloma ◽  
Wide Range ◽  
Critical Issues

Smoldering multiple myeloma (SMM), an asymptomatic plasma cell neoplasm, is currently diagnosed according to the updated IMWG criteria, which reflect an intermediate tumor mass between monoclonal gammopathy of undetermined significance (MGUS) and active MM. However, SMM is a heterogeneous entity and individual case may go from an “MGUS-like” behavior to “early MM” with rapid transformation into symptomatic disease. This wide range of clinical outcomes poses challenges for prognostication and management of individual patients. However, initial studies showed a benefit in terms of progression or even survival for early treatment of high-risk SMM patients. While outside of clinical trials the conventional approach to SMM generally remains that of close observation, these studies raised the question of whether early treatment should be offered in high-risk patients, prompting evaluation of several different therapeutic approaches with different goals. While delay of progression to MM with a non-toxic treatment is clearly achievable by early treatment, a convincing survival benefit still needs to be proven by independent studies. Furthermore, if SMM is to be considered less biologically complex than MM, early treatment may offer the chance of cure that is currently not within reach of any active MM treatment. In this paper, we present updated results of completed or ongoing clinical trials in SMM treatment, highlighting areas of uncertainty and critical issues that will need to be addressed in the near future before the “watch and wait” paradigm in SMM is abandoned in favor of early treatment.

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