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Introduction: Solitary extramedullary plasmacytomas (SEPs) are disease entities characterized by the local proliferation of neoplastic plasma cells, representing less than 6% of plasma cell tumors. They typically produce monoclonal immunoglobulin and are usually found in the head, neck, and, less commonly, in the lungs. SEP, in rare instances, can transition to multiple myeloma (MM) with an estimated risk between 8 and 31%., Case Presentation: We report the case of a 72-year-old woman who sought medical attention at the emergency department due to acute onset dyspnea and syncope. Laboratory results revealed elevated creatinine, hypercalcemia, and anemia, all of which were absent at a hospitalization three months prior for tuberculosis. A chest x-ray showed a right upper lobe opacity, and a computed tomography (CT) scan demonstrated an apical lung mass with calcifications. A CT-guided needle aspiration of the mass indicated SEP. Bone marrow biopsy subsequently confirmed MM. The patient was admitted to the intensive care unit and treated with chemotherapy; however, following a complicated hospital course, she died., Discussion: SEPs are an exceedingly rare form of malignancy with the potential for conversion to MM. Although the likelihood of transformation to MM in months is rare, we call for attention to the possibility of such transition and the clinical prognosis of patients with SEP. Prompt and aggressive treatment is essential, and this, to our knowledge, is the first case of conversion to MM in less than four months following the initial diagnosis of SEP of the lung., (© 2024 Kevan English et al., published by Sciendo.)

Solitary plasmacytoma (SP) is a rare plasma cell dyscrasia. In this retrospective multicenter study, 68 SP patients were included. Compared to solitary extramedullary plasmacytoma (SEP), patients with solitary bone plasmacytoma (SBP) were younger (57.3 vs. 70.9 years, p  = 0.031), had larger plasmacytoma (median: 5.4 vs. 3 cm, p  = 0.007) and higher median involved free light chain level (61 vs. 25.8 mg/L, p  = 0.056). 92.6% of patients were treated by radiotherapy and 11.8% received systemic anti-myeloma treatment. With a median follow-up of 42 months, 45.6% of patients progressed (8.8% - recurrent SP, 36.8% - active myeloma). The median PFS was 58 months and the median OS has not been reached (10-year OS: 84.8%). Patients who received also anti-myeloma treatment had longer PFS compared to those who did not (median not reached vs. 48 months, p  = 0.056). In conclusion, SBP and SEP appear to be different diseases. Radiotherapy is the cornerstone in the SP treatment. A large prospective trial is needed to evaluate the impact of adding systemic anti-myeloma treatment to local radiotherapy.

Breast plasmacytoma is relatively uncommon in which most of the recorded cases were related to disseminated multiple myeloma. However, many of these cases tend to be misdiagnosed with other breast lesions such as breast carcinoma. This article presents a case study on a Libyan female patient around the age of 55 who has a single breast lump, which was first diagnosed to be a malignant lesion. All the results of immunostaining for cytokeratins, GATA3, estrogen receptor, progesterone receptor, HER2, and E-cadherin were negative; hence, the possibility of a breast carcinoma was not considered. However, plasma cell tumors were indicated by the presence of CD138, MUM1, and kappa-light chain markers. In addition, the patient had multiple osteolytic bone lesions, plasma cell infiltration, a monoclonal gammopathy, and signs of renal failure, which considered to be an indication to an extra-medullary breast plasmacytoma secondary to advanced multiple myeloma. This case study emphasizes the necessity of complete histopathological and imaging evolution for proper diagnosis of breast plasmacytoma.

The treatment landscape of multiple myeloma (MM) has been rapidly evolving, leading to improved survival for patients. Given the existence of effective treatment strategies, it is important to not only have better response criteria but also have imaging modalities capable of measuring treatment response, because most patients present with focal bone marrow/bone lesions not captured by myeloma protein and bone marrow examination. Whole body skeletal survey has been considered as a "gold standard" for the determination of the extent of myeloma bone disease at diagnosis., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Purpose of Review: Solitary plasmacytoma is a rare plasma cell dyscrasia, classified as solitary bone plasmacytoma or solitary extramedullary plasmacytoma. These entities are diagnosed by demonstrating infiltration of a monoclonal plasma cell population in a single bone lesion or presence of plasma cells involving a soft tissue mass, respectively. Both diseases represent a single localized process without significant plasma cell infiltration into the bone marrow or evidence of end organ damage. Clinically, it is important to classify plasmacytoma as having completely undetectable bone marrow involvement versus minimal marrow involvement. Here, we discuss the diagnosis, management, and prognosis of solitary plasmacytoma., Recent Findings: There have been numerous therapeutic advances in the treatment of multiple myeloma over the last few years. While the treatment paradigm for solitary plasmacytoma has not changed significantly over the years, progress has been made with regard to diagnostic tools available that can risk stratify disease, offer prognostic value, and discern solitary plasmacytoma from quiescent or asymptomatic myeloma at the time of diagnosis. Despite various studies investigating the use of systemic therapy or combined modality therapy for the treatment of plasmacytoma, radiation therapy remains the mainstay of therapy. Much of the recent advancement in the management of solitary plasmacytoma has been through the development of improved diagnostic techniques.

Multiple myeloma (MM) is a hematological neoplasm characterized by the clonal proliferation of malignant plasma cells in the bone marrow. MM results in diffuse or focal bone infiltration and extramedullary lesions. Over the past two decades, advances have been made with regard to the diagnosis, staging, treatment, and imaging of MM. Computed tomography (CT) and magnetic resonance imaging (MRI) are currently recommended as the most effective imaging modalities at diagnostic. Yet, recent data from the literature suggest that positron emission tomography combined with computed tomography (PET/CT) using 18 F-deoxyglucose (FDG) is a promising technique for initial staging and therapeutic monitoring in this pathology. This paper reviews the recent advances as well as the potential place of a more specific radiopharmaceutical in MM.

Multiple myeloma (MM) is a malignant haematological disease characterised by clonal proliferation of malignant plasma cells in the bone marrow. MM is expressed by diffuse infiltration of the bone marrow, focal bone lesions and extra-medullary lesions. Conventional staging follows the Salmon and Durie classification, which was recently revised (Salmon and Durie plus) to include MRI and FDG-PET examinations. FDG-PET is being evaluated for initial staging and therapeutic monitoring and its place still needs to be validated, particularly in comparison with MRI of the pelvis and spine, the reference examination for diagnosis, which is systematically combined with X-rays of the skeleton. Certain recent data in the literature suggest that FDG-PET provides better staging of the disease at the time of diagnosis than MRI, and that the examination has considerable prognostic value when it normalises after the initial courses of chemotherapy and at the end of treatment. As for the evaluation of lymphomas, the interpretation criteria should be standardised., (Copyright © 2012 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

Multiple myeloma (MM) is a clonal proliferation of plasma cells in the bone marrow, with criteria including bone marrow plasma cells ≥10% or biopsy-proven plasmacytoma with myeloma-defining events. Solitary plasmacytoma (SP) represents a singular clonal plasma cell lesion without myeloma-defining events, while extramedullary disease (EMD) is an aggressive form of MM characterized by independent growth outside the bone marrow microenvironment. We present a unique case of a 64-year-old patient with bilateral testicular plasmacytoma anteceding the development of Immunoglobulin G (IgG) kappa-type MM, featuring extramedullary renal involvement. [ABSTRACT FROM AUTHOR]

Background: Radiotherapy (RT) is the gold standard for solitary plasmacytomas (SP) with great local control. The influence of radiotherapy as well as factors on multiple myeloma (MM) progression is unknown. Materials and methods: We present a retrospective study of 27 patients with SP (bone-SBPand extramedullary-SEP-), treated since 1995 to 2021. We aim to analyze prognostic factors affecting local control and progression to MM in patients treated with radiotherapy (RT). Results: Mean age was 57.3 years. 22 were SBP and 5 SEP. 13 patients were treated with definitive RT, and 14 with a combination of RT and systemic treatment and/or surgery. Local control was observed in 91.5% of cases. 28% experienced progression to MM. With a median follow up of 61.4 months [39.5, 121.6], 5-years MM-free-survival was 81 ± 8%; no individuals progressed further 50 months since diagnosis. Large tumor bulk (> 5 cm) and type (SBP 36% vs. SEP 0%) were associated with progression. Progression was not affected by doses greater than 46 Gy and/or surgery. An immunophenotype different from IgG kappa was predictive of less progression (p = 0.031) in Cox regression analysis adjusted for age, RT dose and tumor bulk > 5 cm. Patients with positron emission tomography-computed tomography (PET-CT) staging showed less MM progression, without statistical differences. Conclusion: RT achieves more than 90% of local control. The immunophenotype IgG kappa showed more risk of progression to MM. Initial staging with PET-CT seems to lead to a better identification of SP. The inclusion of bad prognosis patients in clinical trials would determine the role of adjuvant chemoimmunotherapy in SP treatment. [ABSTRACT FROM AUTHOR]

Solitary plasmacytoma, a B-lymphocyte proliferating neoplastic rare entity can involve facial soft tissue and bone. The presenting case showed diffuse swelling in left mid face with maxillary bone destruction. The lesion was diagnosed as solitary plasmacytoma by conventional histopathology and immunohistochemistry. The case was successfully treated by multi-disciplinary approach with neo adjuvant radiotherapy followed by wide surgical excision without any relapse in three years follow up. [ABSTRACT FROM AUTHOR]

Background: Solitary plasmacytoma of the calvarium (SPC), without evidence of multiple myeloma (MM), is extremely rare. We report a case of a long-standing large SPC that was treated successfully by surgical excision and adjuvant radiotherapy with a long follow-up period. Case Description: A 58-year-old male patient presented with a 5-year history of painless skull swelling. On the physical examination, the mass was 6 × 6 cm in size, oval, not tender, and firm in consistency with normal skin color. A brain computed tomography scan showed a destructive skull lesion. A brain magnetic reasoning imaging (MRI) showed a large expansile lytic mass lesion arising from the skull vault in the frontal-parietal region with multiple internal septa. The patient underwent a craniectomy and excision of the lesion, followed by cranioplasty using methyl methacrylate. The final diagnosis was consistent with plasmacytoma based on the histopathological features. One month follow-up brain MRI showed no evidence of residual tumor. The skeletal survey and bone marrow biopsy did not reveal any evidence of MM. The patient was referred to medical oncology for further treatment and received radiation therapy. During nine years of clinical and radiological follow-up, there was no evidence of any metastasis or recurrence. Conclusion: SPC is a rare disease with high rates of misdiagnosis. Careful evaluations are crucial to exclude systemic involvement. Surgical resection followed by radiotherapy may be adequate for the disease control. Close follow-up with regular lifelong examinations is important to avoid a generalized incurable disease. [ABSTRACT FROM AUTHOR]

Background. Medical care through telemedicine technologies for plasma cell tumors has been provided at the National Medical Research Center for Hematology since 2018. Patients are consulted at the “doctor–doctor” level in the field of “hematology”. Another important aspect of the application of telemedicine at the National Medical Research Center for Hematology is scientific, practical and educational activities aimed at developing remote interaction with medical institutions, developing ways to improve interaction with specialized medical organizations.Aim. To present the implementation of the main applications of telemedicine technologies on the example of paraproteinemic hemoblastoses.Materials and methods. From October 2018 to October 2022 the department of hematology and chemotherapy of paraproteinemic hemoblastoses with bone marrow and hematopoietic stem cells transplantation unit of National Medical Research Center for Hematology received 815 telemedicine requests (701 – primary, 114 – repeated). In 93.6 % of cases, telemedicine consultation was required for multiple myeloma, 2.6 % of requests included information about patients with solitary plasmacytoma, in individual cases, regional hematologists made inquiries about patients with plasma cell leukemia, plasmablastic lymphoma, Waldenstrom’s macroglobulinemia.Results. There has been an annual increase in the number of telemedicine consultations for multiple myeloma. Of the 73 participating regions, the most active were: Tambov Region, Altai Territory, Vladimir Region, Republic of Crimea, Republic of Buryatia, Krasnodar Territory, and Krasnoyarsk Territory. Most of the consultations are aimed at clarifying the tactics of treating multiple myeloma. In 20 % and 22 % of cases, first- and second-line therapy was recommended. In response to 21 % of requests, recommendations were given for the treatment of multiple myeloma complicated by double and triple refractoriness. In 14 % of requests, insufficient information content of medical documentation did not allow expressing an adequate opinion on the tactics of patient management. Hospitalization at the National Medical Research Center for Hematology for the purpose of autologous hematopoietic stem cells transplantation was recommended in 10 % of cases. An analysis of 4 % of telemedicine requests testified to the expediency of palliative treatment and local radiation therapy at the place of residence. The main disadvantages of requests are the lack of primary information when establishing a diagnosis and information on disease monitoring during therapy, as well as the presence of excessive information in medical records.Conclusion. An analysis of telemedicine consultations for paraproteinemic hemoblastoses over a 4‑year period indicates a high need for regional hematologists to discuss therapy tactics with doctors from the federal center. Through telecommunications between doctors of National Medical Research Center for Hematology and the region, in some cases, the full range of diagnostic and therapeutic measures is ensured, which contributes to improving the quality of medical care.

Central nervous system (CNS) manifestations of plasma cell neoplasms are exceedingly uncommon. CNS multiple myeloma (MM) carries a dismal prognosis, and limited evidence exists to guide management of these patients. We report on 3 adult patients with plasma cell neoplasms that presented with CNS manifestations. After summarizing their clinical presentation along with radiologic and pathologic findings, we focus on the patients’ differential management depending on extent of disease while reviewing the literature on frontline therapy in this rare disease scenario.

Solitary plasmacytoma (SP) is characterized by localized proliferation of neoplastic monoclonal plasma cells (PCs) without evidence of systemic disease. We report a case of SP of the uncommon site mandible and highlight the importance of early diagnosis and a systemic workup to rule out multiple myeloma.

Multiple myeloma is a malignant disease usually originating in the bone marrow, although other tissues may be involved. A plasmacytoma is considered to be a solitary form of multiple myeloma. Solitary bone plasmacytoma representing 3% to 7% of myelomas.We present a man 50-year-old with isolated left flank pain that progressed to back pain with acute numbness and tingling in his lower extremities.MRI detected a single malignant osteolytic process of the spine involving T12 with a pathologic fracture leading to segmental kyphosis.There were no abnormalities to be highlighted in the laboratory. Urgent surgery using Closing Posterior – Opening Anterior Wedge osteotomy was conducted.Histopathological examination specimen showed diffuse proliferation of medium to large plasmacytoid cells. The differential diagnosis included NHL, EMP, SPB, MM, and PBL.Based on the radiographic features, Serum protein electrophoresis and bone marrow, MM was ruled out. A diagnostic workup was done with a panel of following IHC markers. Final diagnosis of SPB was made.The patient recovered well. Follow-up X-ray showed the correction of kyphosis after spinal fusion.Solitary plasmacytoma should be included in the differential diagnosis of a solitary lytic lesion.Closing Posterior – Opening Anterior Wedge osteotomy is an effective method to correct post-plasmacytoma kyphosis.

Background. Multiple myeloma (MM) is a kind of malignancy from malignant plasma cells with high intra- and interpatient variability, because of complex clonal evolution of tumor cells. Positron emission tomography combined with computed tomography with 18F-fluorodeoxyglucose (18F-FDG-PET/CT) plays a major role in MM visualization, but there are evidences of non-FDG-avid cases of MM. Taking into account the increasing role of 18F-FDG-PET/CT in MM, special criteria for risk-group stratification was elaborated. These criteria are based on comparison of radiotracer uptake in tumor tissue, mediastinal blood pool and liver.Objective: the study of 18F-FDG uptake in MM and solitary plasmacytoma before antitumor treatment to assess the applicability of criteria based on the ratio of activity in tumor tissue and liver.Materials and methods. We reviewed 65 18F-FDG-PET/CT scans of patients with MM and solitary plasmacytoma before treatment.Results. In our cohort we identified 2 tumor cases of a plasma cell nature, which amounted to 2 % among all B-NHLs. In one case, the process was located in the nasal cavity and clinically manifested itself with nosebleeds. The second case is a lesion of the mouth floor, primarily with the ulcer formation. In the first cases, at diagnosis, the immunohistochemistry (IHC) test was performed after patient’s chemotherapy and radiation treatment, which distorted the tumor immunophenotype. In the second cases with extensive process in maxillary sinuses, a complete and very detailed IHC test was carried out; however the data did not allow for a definitive diagnosis. Difficulties apparently arose in the interpretation of CD38 expression – main marker of plasmacytic line cells, as well as due to the unusual morphology.Conclusion. Therefore, 5-point scale is eligible for MM tumor assessment in 52 % of patients and feasible in 32 % of patients, but in 16 % patients alternative criteria are required.

Solitary plasmacytoma is a rare clonal plasma cell tumor, representing 2-5% of plasma cell disorders. The standard treatment is local radiotherapy. However, in some cases, its use is limited by the size and/or location of the mass. Systemic chemotherapy may be a useful therapeutic alternative. We describe a case of a 27-year-old male with a bulky solitary plasmacytoma arising in the posterior mediastinum, causing spinal cord compression. Radiotherapy was considered risky as the mass was located in the heart and left lung fields. Systemic treatment was given. After the first cycle of cyclophosphamide, bortezomib, and dexamethasone (VCD), the patient attained full neurological recovery. After four VCD cycles, complete remission was achieved. Autologous stem cell transplantation was given as consolidation therapy. At 3 months post-transplantation, the patient is in full clinical recovery and complete metabolic remission on 18FDG PET-CT. Although infrequent, plasma cell disorders must be considered in adult patients with a bulky tumoral mass in the posterior mediastinum. PET-CT is the whole-body imaging technique of choice to detect SP, to evaluate response to treatment and during follow-up.

Lympho plasmacytoma is distinct type of diffuse large B cell lymphoma predominantly seen in HIV-positive patients. The diagnosis of lympho plasmacytoma could be a challenge due to its overlapping characterizes with those of myeloma and lymphoma. We report a case of a 50-year-old man who initially presented with a painful solitary destructive lesion at the second lumbar vertebra. Clinico-pathological findings were consistent with a solitary plasmacytoma, and he was treated with definitive radiotherapy. Eight months after completing radiotherapy, he was found to have similar lesions at D4 vertebral body, multiple ribs, and pelvis. Subsequent biopsy confirmed lympho plasmacytoma. Because of its rarity and heterogeneous presentations, lympho plasmacytoma could easily be overlooked clinically and pathologically in immunocompetent patients. The diagnosis of lympho plasmacytoma should be considered when there is coexpression of myeloma and lymphoma immune markers. [ABSTRACT FROM AUTHOR]

Introduction: The plasma cell neoplasms may present in soft tissue as extramedullary plasmacytomas, bone as a solitary plasmacytoma of bone, or as part of the multifocal disseminated disease multiple myeloma. Aim of study: The study aims to report solitary plasmacytoma in the gnatic bone oral cavity, which is also mimicking as malignant neoplasm of bone, seen in a female patient. Case Report: A 38-year-old female patient reported to the outpatient department of our hospital complaining of pain and swelling over the left lower one-third region of the face for one month CBCT analysis shows a hypodense area involving 35 regions extending towards ascending rami of the mandible. Conclusion: Plasmacytoma, despite being a lesion with slow, asymptomatic growth, can assume large volumes, making proper treatment difficult. When there is no bone involvement and it is diagnosed early, the success of treatment is generally higher. The treatment of choice is radiotherapy, with good results for the remission of the lesion. [ABSTRACT FROM AUTHOR]

Objectives: Solitary plasmacytoma (SP) is characterized by a single mass of clonal plasma cells. Definitive RT can result in long-term local control of the SP. Due to the small number of patients and narrow range of doses, phase III randomized trials are lacking. The aim of this study is to further support the potential use of RT for the treatment of SP. Methods: Clinical data of all patients treated for SP at our Institution between 1992 and 2018 were reviewed. A total of 42 consecutive patients were analyzed. Results: The median follow-up was 84.8 months. Radiation dose did not differ significantly as a function of sex, type of SP (solitary bone plasmacytoma or as extramedullary plasmacytoma), tumor size; conversely differs significantly as a function of age (p = 0.04). The 5y-OS and 10y-OS were, respectively, 96 and 91%. Local recurrences developed in 21.4% of patients (9/42). 16 patients progressed to MM (38.1%). The 5y-progression to MM free survival (PMFS) and the 10y-PMFS were, respectively, 68.6 and 61.9%. Conclusions: Our data confirm that good results are achievable with RT to treat SP, but they don't allow defining a dose–effect correlation; therefore, it remains uncertain which is the most effective dose and whether lower doses can guarantee adequate disease control. [ABSTRACT FROM AUTHOR]

Background: Solitay bone plasmocytoma (SBP) account for just 5-10% of all plasma cell neoplasms. They are infrequent in the cervical spine, especially involving the C0-C2 segment. In this article we conducted a literature review and present the diagnosis, management and long term course of two patients with SBP of C2 causing cervical instability. Methods: We assessed the clinical records of two patients with SBP in C2 and cervical instability attributed to SP-B involving C2. Both patients presented with progressive, severe cervicalgia, and the "sensation" of skull instability. Magnetic resonance imaging revealed an extensive, infiltrative lesion involving C2 vertebral body and lateral masses, consistent with a plasmacytoma. Results: Both patients underwent emergency posterior surgical stabilization with craniocervical fixation; this was accompanied by a C2 transpedicular biopsy. Postoperatively, patients exhibited no focal neurological deficits and rapidly became pain free. They additional recieved 25 sessions of local conventional radiation therapy. Both patients are doing well as respective 2 and 7-year follow-up. Conclusion: Although rare, unstable SBP may present atypical cervical location that readily responds to surgical descompression/fusion and radiotherapy. [ABSTRACT FROM AUTHOR]

Plasma cell leukaemia is a clinical condition in which plasma cells circulating in the peripheral blood constitute >20% of white blood cells (WBC) and there is evidence of plasma cell monoclonality. It is important to be diagnosed early for better treatment outcome. Although it is a rare disease, cases have been reported from Pakistan and other countries (including our neighbouring countries), hence making this case report. After taking history of present and past ailments, physical examination was carried out. Blood and bone marrow sampling were done after taking informed written consent from the patient. Blood samples were obtained in plain bottle, anticoagulated bottle and bone marrow was obtained from posterior iliac spine under 2% lignocaine. Plasma cell leukaemia is a rare and aggressive disease, difficult to diagnose and treat, requires early recognition and therapeutic intervention. [ABSTRACT FROM AUTHOR]

We retrospectively analyzed a large study to investigate the association of hepatitis B virus (HBV) with aggressive B cell non-Hodgkin's lymphoma (aggressive B-NHL) in China, where HBV is endemic. HBV was present in 39 aggressive B-NHL patients (10.46%), 13 indolent B-NHL patients (5.09%), 12 multiple myeloma (MM) patients (3.67%), and 5 solitary plasmacytoma (SP) patients (6.67%). HBV infection was significantly associated with increased risks for aggressive B-NHL (P < 0.01). HBV seems to have a very important role in the pathogenesis of aggressive B-NHL in China. [ABSTRACT FROM AUTHOR]

Purpose: Solitary plasmacytoma (SP) is a rare plasma-cell neoplasm, which can develop both in skeletal and/or soft tissue and frequently progresses to multiple myeloma (MM). Our aim was to study the metabolic behavior of SP and the role of 18F-FDG-PET/CT in predicting progression to MM. Materials and methods: Sixty-two patients with SP who underwent 18F-FDG-PET/CT before any treatment were included. PET images were qualitatively and semiquantitatively analyzed by measuring the maximum standardized uptake value body weight (SUVbw), lean body mass (SUVlbm), body surface area (SUVbsa), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and compared with age, sex, site of primary disease, and tumor size. Results: Fifty-one patients had positive 18F-FDG-PET/CT (average SUVbw was 8.3 ± 4.7; SUVlbm 5.8 ± 2.6; SUVbsa 2 ± 1; MTV 45.4 ± 37; TLG 227 ± 114); the remaining 11 were not 18F-FDG-avid. Tumor size was significantly higher in patients avid lesions compared to FDG not avid; no other features are associated with FDG-avidity. Progression to MM occurred in 29 patients with an average of 18.3 months; MM was more likely to develop in patients with bone plasmacytoma and in patients with 18F-FDG avid lesion. Time to transformation in MM (TTMM) was significantly shorter in patients with osseous SP, in 18F-FDG avid lesion, for SUVlbm > 5.2 and SUVbsa > 1.7. Conclusions: 18F-FDG pathological uptake in SP occurred in most cases, being independently associated with tumor size. PET/CT seemed to be correlated to a higher risk of transformation in MM, in particular for 18F-FDG avid plasmacytoma and SBP. Among semiquantitative features, SUVlbm > 5.2 and SUVbsa > 1.7 were significantly correlated with TTMM. [ABSTRACT FROM AUTHOR]

Extramedullary solitary plasmacytoma (EMP) is a rare type of malignancy. This paper presents a retrospective review of the experience with EMP at the Krakow Oncology Center. Records of 17 patients with head and neck EMP, treated with definitive radiotherapy between 1976 and 2009, were analyzed. The total tumour dose ranged from 45 to 70 Gy (median 56 Gy). In four patients with partial response after radiotherapy, adjuvant melphalan-based chemotherapy was applied. The median follow-up period was 8.6 years. The treatment was well tolerated. The estimated 10-year overall survival, disease-free survival, and multiple myeloma-free survival were 68.4%, 49.3%, and 55%, respectively. The 10-year local control rate was 90.9%. No in-field local recurrence was observed. During the follow-up, progression into multiple myeloma was observed in five patients, with a mean time to conversion of 24 months. The only factor adversely affecting overall survival on univariate analysis was the age >56 years, whereas a complete tumour regression after radiotherapy was associated with a significant improvement in both disease-free survival and multiple myeloma-free survival. Despite the high effectiveness of local radiotherapy, there is still a significant treatment failure risk due to the EMP conversion into generalized disease. An attempt to identify prognostic factors may facilitate selection of patients with a high risk of progression to multiple myeloma. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

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Objective: to consider clinical practice problems in the differential diagnosis of different types of plasma cell dyscrasias (PCD). Subjects and methods. Fourteen patients (8 men and 6 women) aged 52±12 years, in whom rheumatic diseases (RD) were ruled out and who were diagnosed as having primary PCD: different types of myeloma in 7 patients, myeloma + AL-amyloidosis in 2, AL-amyloidosis in 3, and Waldenstrom’s macroglobulinemia in 2, were examined. Results and discussion. The most common maldiagnosed RDs in patients with PCD were seronegative rheumatoid arthritis (RA), systemic lupus erythematosus, Sjogren’s disease, and different forms of vasculitis. The most frequent masks of RD were kidney (78%) and osteoarticular system (64%) lesions, vascular disorders (36%), peripheral polyneuropathies (36%), and enlarged salivary glands with xerostomia (28.5%). Serum and urine immunochemical study should be performed in all patients who have clinical manifestations of seropositive RA, spondyloarthritis, intensive bone pain syndrome, ulceronecrotic vasculitis, enlarged submandibular salivary glands with macroglossia in the absence of markers of autoimmune disease for the timely diagnosis of PCD and the exclusion of RD. The paper estimates the sensitivity and specificity of main methods used to diagnose different types of PCD.

Solitary plasmacytoma (SPC) of the skull (SPS) is rare, and only a few cases have been reported in the literature so far. Plasmacytoma of the skull has a wide spectrum of pathology, including a quite benign, SPC, and an extremely malignant, multiple myeloma at the two ends of the spectrum. SPC of bone including SPS is characterized by a radiologically solitary bone lesion, neoplastic plasma cells in the biopsy specimen, fewer than 5% plasma cells in bone marrow,

Plasma-cell neoplasms are classically categorized into four groups as: multiple myeloma (MM), plasma-cell leukemias, solitary plasmacytomas (SP) of the bone (SPB), and extramedullary plasmacytomas (EMP). These tumors may be described as localized or diffuse in presentation. Localized plasma-cell neoplasms are rare, and include SP of the skeletal system, accounting for 2-5% of all plasma-cell neoplasms, and EMP of soft tissue, accounting for approximately 3% of all such neoplasms. SP is defined as a solitary mass of neoplastic plasma cells either in the bone marrow or in various soft tissue sites. There appears to be a continuum in which SP often progresses to MM. The main treatment modality for SP is radiation therapy (RT). However, there are no conclusive data in the literature on the optimal RT dose for SP. This review describes the interrelationship of plasma-cell neoplasms, and attempts to determine the minimal RT dose required to obtain local control.

Background: Primary solitary plasmacytoma (PSP) of the skull base is a rare localized monoclonal plasma cell dyscrasia with normal or low plasma cell infiltration. Differentiating from other skull base tumors based on radiologic findings is difficult due to nonspecific features. PSP has a better prognosis after surgical resection and adjuvant radiotherapy, unless the tumor progresses to multiple myeloma (MM). Nonetheless, 50-60% progress to MM within a median time of 2 years. Gross total resection (GTR) for PSP is controversial for improving overall survival. However, if the lesion is easily accessible, for example, nonskull base lesion, GTR is still advocated. Case Description: A 67-year-old male patient presented with right occipital neuralgia and diplopia in the last year. Neurological examination revealed mild abducens paresis on the right side. Brain MRI scan showed a large petroclival bony extradural mass lesion on the right side, with homogeneous enhancement, extending from the dorsum sellae to the ipsilateral occipital condyle and involving the petrous carotid artery. Brain CT scan revealed an osteolytic lesion without intratumoral calcifications, sclerotic border, or periosteal reaction. Anterior petrosal approach was performed and GTR was achieved. The patient had good postoperative outcome and improvement of symptoms. Postoperative MRI revealed GTR. Total body imaging work-up and immunohistochemistry confirmed PSP. Conclusion: Although the extent of resection in the outcome is controversial, maximal safe resection of skull base PSP should be considered to improve symptoms and quality of life. [ABSTRACT FROM AUTHOR]

Purpose: Multiple myeloma (MM) and solitary plasmacytoma of bone (SPB) are two independent subtypes of plasma cell dyscrasias which often occur in spine. However, little is known about the surgical treatment of patients with spinal instability or neurological impairment caused by spinal lesions as the first clinical manifestation. The present study aimed to investigate the surgical outcome of these patients. Methods: We retrospectively reviewed the data of a total of 64 patients receiving spinal surgery in our center, in which 30 were diagnosed as MM and 34 as SPB. Univariate and multivariate analyses were used to identify factors associated with overall survival (OS) and progression-free survival (PFS) of patients. Results: Surgical treatment led to favorable results including pain relief, resumption of ambulatory ability as well as improvement of neurological function and life quality. Univariate analysis suggested that the potential prognostic factors for OS of MM patients were bisphosphonate treatment, post-surgical ambulatory status, Karnofsky Performance Score (KPS) and Frankel scale, and for PFS of MM patients were age at surgery, resection mode, postoperative ambulation status, KPS and Frankel scale, while the PFS of SPB patients was only significantly related to postoperative adjuvant therapies. Multivariate analysis indicated that postoperative ambulation status was the only independent risk factor for both OS and PFS of MM patients. Conclusions: Surgery may be beneficial to patients with spinal instability or neurological impairment caused by spinal lesions as the first clinical manifestation, in which MM patients with postoperative ambulatory ability display better prognosis. [ABSTRACT FROM AUTHOR]