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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%.

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]

We report a case of a 40-year-old female with a solitary plasmacytoma of the right transverse apophysis of C1 who underwent combined transoral ablation using a curved steerable needle and cementoplasty under CBCT and infra-red augmented reality navigation system. An imaging work-up revealed an osteolytic lesion determining partial collapse of the right lateral mass of C1 and involving the vertebral foramen. After a biopsy, that revealed a solid tissue consistent with plasmacytoma, it was decided to proceed with radiation therapy. Subsequent PET-CT restaging scans showed residual tumors treated with a transoral percutaneous approach, combining ablation and cementoplasty. This report evaluates the benefits of this combined procedure and the transoral approach, focusing on the advantages of steerable devices and navigation systems.

Solitary plasmacytoma is a rare malignant tumor, presenting less than 5% of all plasma cell proliferation. Bone forms are the most frequent, affecting particularly the axial bone skeleton, mandibular localization is extremely rare. Diagnosis is based on the presence of a localized plasma cell tumor without signs of a disseminated form. We report a case of 65 years old female patient with solitary bone plasmacytoma of mandible, who has undergone surgical treatment without adjuvant therapy, with a good clinical and radiological outcomes at 12 months follow-up.

Plasmacytoma of the skull base is a rare entity. We present a case of sphenoid plasmacytoma in a 51‐year‐old woman who had nasal obstruction, intermittent epistaxis, headaches, decreasing visual acuity, and diplopia. Computed Tomography (CT) scan and magnetic resonance imaging (MRI) showed a large heterogeneous, expansile lesion measuring 75 mm × 54 mm, centered on the sphenoidal bone and the clivus. Biopsy confirmed the diagnosis of solitary plasmacytoma after ruling out systemic spread by the initial assessment. The patient was successfully managed by external beam radiotherapy and a complete response was obtained after 12 months of follow-up.

Background: Parasellar plasmacytomas are rare neurosurgical entities. Intrinsic characteristics of these tumors, such as adjacent bone erosion and symptoms resulting from invasion and mass effect, may lead to the possibility of a solitary extramedullary plasmacytoma (SEP) as a differential diagnosis. Case Description: We present the case of a 39-year-old male with a 1-month history of bilateral decreased visual acuity, retroocular pulsating pain, and chromatic vision loss. A computed tomography scan of the head revealed a parasellar lesion causing chiasmatic compression, as well as clival, orbital, sphenoidal, and ethmoidal invasion. A combined transorbital and endonasal endoscopic approach was found suitable, and gross total resection was achieved. Histological analysis of the lesion established the diagnosis of a SEP. After radiotherapy, a new magnetic resonance imaging was performed, revealing a recurrence of the lesion with a high grade of invasion. The patient was treated with palliative radiotherapy, as surgical resection did not seem feasible. Conclusion: Surgical resection and radiotherapy may achieve remission of these lesions; however, recurrence rates remain high despite any treatment modality. Patients with this condition must be followed up with a multidisciplinary team due to the high risk of multiple myeloma progression. [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.

Around 5% of plasma cell neoplasias are solitary plasmacytomas, a tumor that is fairly rare. The presence of a localized tumor composed of monoclonal plasma cells that are the same as those found in multiple myeloma and the absence of symptoms that would suggest a disseminated form are used to establish the diagnosis. The thoracolumbar spine is the area most affected. Costal origin is infrequently described. In our case, the patient manifested a right anterosuperior chest wall mass. Imaging showed a mass of tissue with a significant zone of osteolysis of the first rib and no chest wall infiltration. Blood protein immunoelectrophoresis disclosed a monoclonal kappa type IgG. Bence-Jones proteinuria was positive, further suggesting a plasmacytoma of the rib. A percutaneous needle biopsy for pathology study and immunohistochemistry enabled the diagnosis of costal plasmacytoma. Search for other localizations was negative and the diagnosis of solitary plasmacytoma was retained. The patient received radiotherapy and has remained in remission for over a year. The pathology and imaging findings are used to make the diagnosis. Radiotherapy is the therapy of choice, but it presents a risk of progression to other bone lesions, medullary plasmacytosis, and multiple myeloma. There are no known factors that predict systemic recurrence. Surveillance is essential on a regular basis.

This case is reported to increase the awareness among clinicians about the malignant lesions of the clavicle. Plasmacytoma is a rare tumor occurring in the clavicle. Here, we report a 55-year-old female who presented with swelling in her left clavicle for 2 months associated with no pain. On examination, diffuse swelling was noted over the medial end of clavicle, nontender, hard in consistency, and ill-defined margin. Radiograph of the left clavicle showed an expansile lytic lesion. Ultrasonography neck revealed an expansile lesion in the medial end of the left clavicle with matted lymph nodes. Fine-needle aspiration cytology from clavicular lump showed plasma cell in hemorrhagic background. Excision biopsy of the lesion showed sheaths of plasma cells with eccentric placed nuclei confirming the diagnosis of plasmacytoma of clavicle. Plasmacytoma of the clavicle is a rare entity; there is a need for physicians to recognize the epidemiology and radiological findings and offer the suitable treatment options.

Solitary plasmacytoma of bone of the spine (SPBS) was rarely detected in the past. However, its incidence has gradually increased with improvements in the diagnosis and understanding of the disease. We aimed to conduct a population-based cohort study to characterize the prevalence and factors associated with SPBS and develop a prognostic nomogram for predicting the overall survival of SPBS patients with a real-world analysis based on the surveillance, epidemiology, and end results database. Patients with SPBS at diagnosis were identified using the SEER database from 2000–2018. Multivariable and univariate logistic regression analyses were used to identify factors for developing a novel nomogram. Nomogram performance was evaluated using the calibration curve, area under the curve (AUC), and decision curve analyses. Kaplan–Meier analysis was used to estimate survival durations. A total of 1,147 patients were selected for survival analysis. Multivariate analysis demonstrated that independent predictors for SPBS were as follows: ages: 61–74 and 75–94, marital status: unmarried, treatment: radiation alone and radiation with surgery. The 1-, 3-, and 5-year AUCs for OS were 0.733, 0.735, and 0.735 in the training cohort and 0.754, 0.777, and 0.791 in the validation cohort, respectively. The C-index values in the 2 cohorts were 0.704 and 0.729. The results indicated that nomograms could satisfactorily identify patients with SPBS. Our model effectively demonstrated the clinicopathological features of SPBS patients. The results indicated that the nomogram had a favorable discriminatory ability, good consistency, and yielded clinical benefits for SPBS patients. [ABSTRACT FROM AUTHOR]

Study Design. Retrospective analysis. Objective. This study aimed to establish nomograms for predicting overall survival (OS) and cancer-specific survival (CSS) in patients with solitary plasmacytoma of the spine (SPS). Summary of Background Data. SPS is a rare type of malignant spinal tumor. A systematic study of prognostic factors associated with survival can provide guidance to clinicians and patients. Consideration of other causes of death (OCOD) in CSS will improve clinical practicability. Methods. A total of 1078 patients extracted from the SEER database between 2000 and 2018 were analyzed. Patients were grouped into training and testing data sets (7:3). Factors associated with OS and CSS were identified by Cox regression and competing risk regression, respectively, for the establishment of nomograms on a training data set. The testing data set was used for the external validation of the performance of the nomograms using calibration curves, Brier's scores, C-indexes, time-dependent receiver operating characteristic curves, and decision curve analysis (DCA). Results. Age and grade were identified as factors associated with both OS and CSS, along with marital status, radiation for OS, and chemotherapy for CSS. Heart disease, cerebrovascular disease, and diabetes mellitus were found to be the 3 most common causes of OCOD. The nomograms showed satisfactory agreement on calibration plots for both training and testing data sets. Integrated Brier score, C-index, and overall area under the curve on the testing data set were 0.162/0.717/0.789 and 0.173/0.709/0.756 for OS and CSS, respectively. DCA curves showed a good clinical net benefit. Nomogram-based web tools were developed for clinical application. Conclusion. This study provides evidence for risk factors and prognostication of survival in SPS patients. The novel nomograms and web-based tools we developed demonstrated good performance and might serve as accessory tools for clinical decisionmaking and SPS management. [ABSTRACT FROM AUTHOR]

Solitary plasmacytoma is a rare neoplasm characterized by localized proliferation of monoclonal plasma cells and is classified as solitary bone or solitary extramedullary plasmacytoma. Here, we present two rare cases of plasmacytoma of the head and neck. The first is a 78-year-old male who presented with a 3-month history of epistaxis and progressive obstruction of the right nasal passage. Computerized tomography (CT) imaging revealed a mass in the right nasal cavity with destruction to the maxillary sinus. An excisional biopsy was performed revealing anaplastic plasmacytoma. The second is a 64-year-old male with a past medical history significant for prostate cancer who presented with a 2-month history of left ear pain and progressive non-tender temporal swelling. A PET/CT revealed a highly avid, destructive, and lytic left temporal mass with no other evidence of distant disease. A left temporal craniectomy and infratemporal fossa dissection revealed plasma cell dyscrasia with monoclonal lambda in situ hybridization. Although plasmacytomas are uncommon tumors of the head and neck, they may mimic other entities that require different treatment. Prompt and accurate diagnosis is critical for appropriate therapeutic decisions and prognosis. [ABSTRACT FROM AUTHOR]

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.

Extramedullary plasmacytoma (EMP) is a rare disease consisting of the presence of monoclonal plasma cells in tissues other than the bone. Most EMPs are located in the head and neck region. We present an extremely rare case of an EMP originating from the biliary tract in a 76-year-old male. This is the fifth report of a primary EMP arising from the biliary tract. He was diagnosed with jaundice, and he was referred for an additional examination. Abdominal ultrasonography revealed a tumor in the gallbladder and bile ducts, and a bile duct biopsy was performed via endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The pathological and immunohistochemical examination revealed that the tumor was a plasmacytoma originating in the biliary tract. Although endoscopic biliary drainage was performed, the bile duct infection was not well controlled due to obstructive jaundice caused by the tumor. Furthermore, the bleeding from the tumor during chemotherapy was uncontrolled. Pancreaticoduodenectomy and cholecystectomy were performed to control the infection and bleeding. Although chemotherapy was continued after surgery, the tumor of the intrahepatic bile duct enlarged. He died seven months after the diagnosis because of the treatment-resistant tumor. [ABSTRACT FROM AUTHOR]

Background: Solitary plasmacytoma (SP) caused the collapse/destruction of the C2 vertebral body in a 78-year-old male. To provide sufficient posterior stabilization, the patient warranted lateral mass fusion to supplement the bilateral pedicle/screw rod instrumentation. Case Description: A 78-year-old male presented with neck pain alone. X-rays, computed tomography, and magnetic resonance studies documented C2 vertebral collapse with the complete destruction of both lateral masses. The surgery required a laminectomy (i.e., bilateral lateral mass resection), plus placement of bilateral expandable titanium cages from C1 to C3 to supplement the screw/rod occipitocervical (O-C4) fixation. Adjuvant chemotherapy and radiotherapy were also administered. Two years later, the patient remained neurologically intact and radiographically had no evidence of tumor recurrence. Conclusion: In patients with vertebral plasmacytomas and bilateral lateral mass destruction, posterior occipital-cervical C4 rod/screw fusions may warrant the additional bilateral placement of titanium expandable lateral mass cages from C1 to C3. [ABSTRACT FROM AUTHOR]

Introduction: Solitary plasmacytomas are tumors characterized by a local increase of malignant plasma cells in soft tissue or bone and may occur anywhere without evidence of systemic disease. The aim was to focus on the main surgical techniques and outcomes for this rare chest wall tumor., Methods: Patients with solitary plasmacytoma involving a rib, who were operated for diagnostic or treatment purposes between 2018 and 2023 were retrospectively reviewed., Results: Of the six patients included, three were male and the median age was 55.6 (range: 32-74) ys. All patients had preoperative positron emission tomography-computed tomography. Two underwent Tru-cut biopsy before surgery, but only one was then diagnosed. Two patients underwent surgery for diagnosis and the remainder underwent resection and reconstruction. In one patient with both rib and sternum involvement, rib and partial sternum resection was performed and the defect was repaired with mesh. During the 24.1 mos average follow-up period, two patients died, both of whom had metastasis preoperatively. The median survival of all patients was 24.1 (range: 3-63) mos., Conclusions: Solitary plasmacytoma is rarely seen among primary malign tumors of the chest wall. A multidisciplinary approach is important in these cases. Surgical treatment in solitary plasmacytoma has fewer local and systemic side effects compared to radiotherapy and chemotherapy. Therefore, the place of surgery in the treatment of solitary plasmacytoma should be revised. Our findings show that surgery should be considered as not only a palliative treatment, but also a curative one, in solitary plasmacytomas arising in the rib., (Copyright © 2025 Elsevier Inc. All rights reserved.)

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. [ABSTRACT FROM AUTHOR]

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.

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. [ABSTRACT FROM AUTHOR]

POEMS syndrome is a rare multisystem disorder that clinically manifests as a paraneoplastic syndrome and monoclonal plasma cell dyscrasia. Its acronym is derived from its principal characteristics: polyneuropathy, organomegaly, endocrinopathy, M proteins, and skin changes. Here, a case of POEMS syndrome was reported also having features of Castleman disease. A 43-year-old man was admitted with weakness of all four limbs, tingling, heaviness, muscle cramps along with headache for the last 6 months; examination revealed flaccid quadriparesis, generalized areflexia with flexor plantar response, papilloedema, cervical lymphadenopathy, hepatomegaly, tender mass at the left parieto-occipital region, pitting edema and testicular atrophy. Laboratory tests revealed thrombocytosis, high blood sugar, hepatomegaly, lytic lesions at the left parietal bone, pelvis, and intraosseous mass in the Pareto-occipital region; nerve conduction study showed the demyelinating motor neuropathy without conduction block. Intraosseous mass biopsy showed solitary plasmacytoma and immunohistochemical markers positive for CD138 and Ki- 67 MUM-1 and lambda/kappa >10:1, suggesting plasma cell dyscrasia with lambda chain restriction. Biopsy from the cervical lymph node revealed features of Castleman disease. With these clinical and laboratory parameters, this case was finally diagnosed as POEMS syndrome in association with Castleman disease which is a common accompaniment with the syndrome. [ABSTRACT FROM AUTHOR]

A 65-year-old woman presented with fever and abnormal behavior. Magnetic resonance imaging showed swelling of the left medial temporal lobe and an intracranial extra-axial occipital tumor. While her neurological symptoms improved after the administration of corticosteroid therapy under the suspicion of autoimmune encephalitis, the occipital tumor unexpectedly shrank, and the diagnosis of a solitary plasmacytoma was confirmed by biopsy. Additional examinations revealed elevated anti-glutamate receptor antibodies in the cerebrospinal fluid. The patient was diagnosed with autoimmune encephalitis concurrent with an intracranial solitary plasmacytoma. Central nervous system involvement can be considered a neurological complication in patients with a solitary plasmacytoma.

Solitary plasmacytoma is a rare malignant tumor belonging to the family of plasma cell proliferation. It accounts for a small portion of plasma cell tumors and remains a rare condition. We report three cases of rare extraosseous plasmacytomas in young patients. Case 1 describes a 55-year-old patient with multiple cutaneous plasmacytomas who underwent a watchful waiting approach. Case 2 discusses a 44-year-old patient with nasal plasmacytoma who was successfully treated with exclusive radiotherapy. Case 3 reports on a 52-year-old patient with a solitary ovarian plasmacytoma who underwent surgical resection and did not receive adjuvant treatment due to complete resection. The patients did not have multiple myeloma and had different treatment approaches based on the location and extent of the plasmacytoma. Local recurrence and progression to multiple myeloma may occur, justifying prolonged and rigorous monitoring., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Halloumi et al.)

Plasma cell neoplasms consist of a range of disorders from Monoclonal Gammopathy of Undetermined Significance to Multiple Myeloma. Solitary plasmacytomas are a part of this. Most commonly occur in bone. Extramedullary solitary plasmacytomas are extremely rare. Here we report a case of solitary plasmacytoma of breast which is extremely rare. The incidence is of the order of 0.01%. A fifty-year old postmenopausal female came to our Opd with the chief complaint of lump in lower inner quadrant of left breast since thirty to forty days. History and physical examination revealed a 3*3 cm firm, non tender palpable lump in upper medial quadrant of left breast. The biopsy revealed to be plasmacytoma. The immunohistochemistry was positive for markers like A full workup was done to rule out lesions in bone and any other site which included Complete Blood Count, Renal function test Serum Calcium, Peripheral Smear, Urine and Serum protein electrophoresis, Bone marrow Biopsy and Bone Biopsy, Skeletal Survey, Whole body PET CT. All these findings confirmed the diagnosis of Extraosseous Solitary Plasmacytoma of Left Breast. The treatment offered was Curative Radiotherapy to Left breast using conformal technique (3DCRT) to a total dose of 40 Gy in 20 fractions (2 Gy/#). The patient was examined weekly for any skin reaction or any other side effect. Dose constraints to organs at risk were kept well within the prescribed limits. After completion of treatment the patient is kept on monthly follow up. Physical examination and routine blood investigations are a part of routine follow up. Solitary plasmacytomas being extremely rare and when occur in soft tissues usually involve the upper aerodigestive tract and oral cavity. Primary involvement of breast in case of solitary plasmacytoma is extremely rare.

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]

Solitary craniocerebral plasmacytoma is the least common form of extramedullary solitary plasmacytoma (SP). Cerebral SP is very rare. The world literature counts only seven intracranial cases. The authors report a case of cerebral tumor of SP in a 52-year-old female who presented to a hospital with headache and difficulty in walking for 6 months. Contrast-enhanced computed tomography (CECT) brain showed left occipital intracranial space occupying lesions (ICSOL) of size 26 mm × 14 mm adjacent to superior sagittal sinus with disproportionate perilesional edema and midline shift toward the right. She underwent gross total tumor excision with left fronto-temporo-parietal decompressive craniectomy. Microscopic sections showed highly cellular tumor infiltrating white matter and gray matter. Histopathology revealed plasmacytoma. These plasma cells were seen infiltrating the adjoining brain parenchyma. Immunohistochemistry study showed the following pattern of antigens: most of the cells were negative to CD138 antibody, and majority of cells were positive (++ to +++) to CD56 antibody, more groups of cells were positive to lambda antibody than KAPPA. Bone marrow biopsy showed only 1% polyclonal plasma cells. Whole body bone scan showed no evidence of any osteoblastic skeletal metastasis. The patient recovered well, and cranioplasty was done after 6 weeks. Conclusion Cerebral SP is rarely found in clinical practice and if diagnosed properly can save patients life. This case report would definitely address many unexplored facts about cerebral SP and set milestone in the field of clinical research.

Solitary plasmacytoma (SP) is a malignant tumor caused by the monoclonal proliferation of plasma cells, representing less than 5% of plasma cell tumors. SP can be categorized into two groups: solitary bone plasmacytoma (SBP) and solitary extramedullary plasmacytoma (SEP). SEP most commonly occurs in the head and neck and is rarely located in the reproductive system. Here, we report a case of a 77-year-old woman with SEP in the cervix who had a 7-day history of vaginal bleeding. Ultrasonography and magnetic resonance imaging (MRI) showed an oval mass in the cervix, which was initially considered as neoplastic lesions and highly suspected to be cervical cancer, but cervical leiomyoma and other benign tumors cannot be completely excluded. Subsequently, cervical biopsy showed that the tumor was SEP, and then the patient underwent surgery. The postoperative pathological diagnosis was also SEP, which confirmed the radiologist’s misjudgment. In conclusion, SEP that occurs in the cervix is remarkably rare, and only nine cases have been reported in the cervix. No case reports to date have described in detail the imaging findings of cervical SEP. This study demonstrates the MRI imaging characteristics of a patient with SEP of the cervix and reviews the imaging findings of SEP reported in the previous literature, in order to provide more extensive insights for radiologists to consider the differential diagnosis of cervical lesions.

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]

Solitary plasmacytoma (SP) is a malignant tumor caused by the monoclonal proliferation of plasma cells, representing less than 5% of plasma cell tumors. SP can be categorized into two groups: solitary bone plasmacytoma (SBP) and solitary extramedullary plasmacytoma (SEP). SEP most commonly occurs in the head and neck and is rarely located in the reproductive system. Here, we report a case of a 77-year-old woman with SEP in the cervix who had a 7-day history of vaginal bleeding. Ultrasonography and magnetic resonance imaging (MRI) showed an oval mass in the cervix, which was initially considered as neoplastic lesions and highly suspected to be cervical cancer, but cervical leiomyoma and other benign tumors cannot be completely excluded. Subsequently, cervical biopsy showed that the tumor was SEP, and then the patient underwent surgery. The postoperative pathological diagnosis was also SEP, which confirmed the radiologist's misjudgment. In conclusion, SEP that occurs in the cervix is remarkably rare, and only nine cases have been reported in the cervix. No case reports to date have described in detail the imaging findings of cervical SEP. This study demonstrates the MRI imaging characteristics of a patient with SEP of the cervix and reviews the imaging findings of SEP reported in the previous literature, in order to provide more extensive insights for radiologists to consider the differential diagnosis of cervical lesions. [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]

Extramedullary solitary plasmacytoma (SP) is an uncommon tumor and is even rare in the head and neck locations. Here, we report the case of an 82-year-old man admitted to our department for the management of nasal cavity SP. Radiological investigation showed a locally advanced tumor making the patient a non-candidate for surgery. The patient had undergone radiotherapy alone to a total dose of 50 Gy, with 2 Gy per fraction five days a week. After a follow-up of nine months, the tumor recurred, and the patient was managed in the internal medicine department. He received palliative chemotherapy with the cyclophosphamide, dexamethasone, and thalidomide protocol which resulted in a good response. This case illustrates the diagnostic challenges and treatment complexities of SP, particularly in rare locations such as the nasal cavity., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Guerrouaz et al.)

Localized proliferation of atypical plasma cells, either at bony or extramedullary, forms a rare subset of multiple myeloma (MM) disorders. The patients usually present with intractable pain and pathological fractures and respond well to radiotherapy. The clinical presentation is variable and radiologically is nonspecific. The spinal location is rare, and the solitary plasmacytoma in the intradural extramedullary (IDEM) region is unusual. Herein, we report the second case of solitary plasmacytoma at the lumbar IDEM region. A 54-year-male patient was referred to our institute with complaints of radicular pain in bilateral lower limbs along L5 dermatome for the past 3 months. The neurological examination was normal with power 5/5 and reflexes 2+, except for bilateral straight leg raising test restricted at 30. Magnetic resonance imaging of spine showed a well-defined eccentrically placed (left Side) spherical lesion at the level of L2 vertebrae. The lesion had foraminal extension and showed minimal contrast enhancement. The underlying ventral vertebral body was irregular and hyperosteotic. Our radiological impression was primarily neurofibroma, but the features were slightly atypical. The patient underwent L1–L2 laminectomy and excision of IDEM tumor. The histopathological features were consistent with plasmacytoma. The histopathology was a surprise to us. We further evaluated the patient for MM. He received adjuvant radiotherapy and is currently asymptomatic. An index of suspicion for SP must be kept among differentials of intradural lesions, especially when adjacent bony changes are present. The diagnosis of plasmacytoma warrants further workup according to the recommendations of the International Myeloma Working Group.

• Plasmacytoma is a rare clonal neoplastic disorder of bone marrow that originates from plasma cells. It usually presents as a multiple myeloma. Less than 5% of patients present with either a single bone lesion as a solitary bone plasmacytoma or, even more rarely, as a soft tissue mass of monoclonal plasma cells representing a solitary extra medullary plasmacytoma (SEP). • Diagnostic criteria of a SEP include a solitary lesion, histopathological confirmation, negative bone marrow examination or clonal plasma cells infiltration less than 10% of all nucleated cells, normal results on skeletal survey, negative urine test for Bence Jones protein, absence of anemia, hypercalcemia or renal impairment, absent or low serum or urinary level of monoclonal immunoglobulins. • The primary treatment for most patients is radiotherapy, but surgery may also be required, and multidisciplinary decision between surgeon, hematologist and radiotherapist is crucial for planning optimum care. • Our case report is unique in the clinical presentation and treatment option (chemotherapy) as the patient refused other treatment options. Plasmacytoma is a rare clonal neoplastic disorder of bone marrow that originates from plasma cells. It usually presents as a multiple myeloma (MM). Less than 5% of patients present with either a single bone lesion as a solitary bone plasmacytoma (SBP) or, even more rarely, as a soft tissue mass of monoclonal plasma cells representing a solitary extra medullary plasmacytoma (SEP). We report a case of a 59-year-old man presenting with a mass of the soft palate evolving for a year. Physical examination showed an extension to the nasal cavity. Biopsy with immunohistochemical study demonstrated sheets of mononucleated plasmacytoid cells diffusely expressing CD138. The plasma cells showed monoclonal light chain Kappa. Further investigations did not show any other locations including bone and bone marrow. Thus, diagnosis of solitary extramedullary plasmacytoma of the soft palate was established. The patient was treated with chemotherapy with total remission on his one year follow-up. SEP may arise in any organ, either as a primary tumor or as part of a MM. Almost 90% of SEP arise in the head and neck, especially in the upper respiratory tract. Primary treatment for most patients is radiotherapy, but surgery may also be required, and multidisciplinary decision between surgeon, hematologist and radiotherapist is crucial for planning optimum care. SEP is an extremely rare condition which requires diagnostic and therapeutic management in the same level of MM. Prognosis is better than the two other forms (MM and SBP). [ABSTRACT FROM AUTHOR]

We retrospectively analyzed 51 patients with solitary plasmacytoma diagnosed from October 2002 to September 2018 from a cohort of 3575 patients with plasma cell dyscrasias registered in the Kansai Myeloma Forum. Twenty-seven patients had solitary bone plasmacytoma (SBP) and 24 had extramedullary plasmacytoma (EMP), with prevalence of 0.8% and 0.7%, respectively. The most frequent M protein was IgG (40%) in SBP, whereas non-secretory proteins were most frequent (50%) in EMP. Five-year overall survival was 78.2% in SBP and 80.8% in EMP (P = 0.894). Among patients with SBP, 44% progressed to MM with a median time of 10.5 months (2.4-93.3 months), whereas 8% of EMP patients progressed to MM with a median time of 18.6 months (13.0-24.2 months). The most frequent treatment was radiotherapy (41%) or observation (41%) in SBP, and chemotherapy (54%) in EMP. No statistically significant difference was observed upon univariate analysis of prognostic factors including age, sex, performance status, and IgG M protein. Our results suggest that there are biological differences between SBP and EMP in real-world settings. [ABSTRACT FROM AUTHOR]

18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) plays a pivotal role in the staging, restaging, and surveillance of various bone tumors, including plasmacytomas and osteosarcomas. Solitary plasmacytomas most frequently occur in the bones and are primarily treated with either surgery or radiotherapy. Radiation-induced osteosarcomas (RIOS) usually develop after a median interval of 11 years between radiation and sarcoma presentation. However, these can rarely present with a short latent period of 4 years or even lesser. In such cases, whole-body imaging plays a vital role in the early detection and management of RIOS. Herein, we present the case of a 29-year-old female patient with solitary plasmacytoma undergoing a follow-up whole-body 18F-FDG PET/CT, which revealed metastatic RIOS after a short latent period. [ABSTRACT FROM AUTHOR]

Abstract Solitary plasmacytoma is an infrequent form of plasma cell dyscrasia that presents as a single mass of monoclonal plasma cells, located either extramedullary or intraosseous. In some patients, a bone marrow aspiration can detect a low monoclonal plasma cell infiltration which indicates a high risk of early progression to an overt myeloma disease. Before treatment initiation, whole body positron emission tomography–computed tomography or magnetic resonance imaging should be performed to exclude the presence of additional malignant lesions. For decades, treatment has been based on high-dose radiation, but studies exploring the potential benefit of systemic therapies for high-risk patients are urgently needed. In this review, a panel of expert European hematologists updates the recommendations on the diagnosis and management of patients with solitary plasmacytoma.

Abstract Background Solitary plasmacytoma of the liver is a very rare and aggressive form of plasma cell dyscrasia. To the best of our knowledge, very few cases have been reported without systemic disease. We reported a rare case of hepatic solitary plasmacytoma that successfully responded to fractionated stereotactic radiotherapy. Case presentation A 64-year-old white French man had monoclonal gammopathy of the immune globulin G lambda type; he developed a cholestasis and cytolysis with the discovery of a subscapular nodule. A biopsy showed plasma cells and, for several reasons, the decision was made to use the fractionated stereotactic radiotherapy strategy. After 20 months, he is asymptomatic and the immune globulin G component has completely disappeared. Conclusion We suggest considering Cyberknife® radiosurgery as an option for the treatment of hepatic solitary plasmacytoma.

Background Context: Solitary plasmacytoma of bone (SPB) can progress to multiple myeloma (MM). Little attention has been paid to the reossification findings on computed tomography (CT) and their correlation with prognosis after radiotherapy with/without surgery.Purpose: To evaluate reossification after radiotherapy and prognostic factors of spinal SPB using single-center data.Study Design: Retrospective observational study.Patient Sample: Patients who had spinal SPB and received radiotherapy with/without surgery, without chemotherapy, denosumab or zoledronic acid.Outcome Measures: MM progression rate, mortality rate, and reossification rate at 12 months.Methods: This retrospective clinical review included 39 patients who underwent radiotherapy as first-line treatment for SPB in the spine. External radiation was divided into 20-25 fractions with a total dose of 35-46 Gy. At the 12-month follow-up after the index radiotherapy, significant and mild reossification, defined as bone formation with ≥30% or 0%-30% increase, respectively, in bony area based on increase in CT values were documented, along with progressive disease, which was a decrease in bony area with lesion enlargement. This study was funded by AO Foundation, AOSpine (AOSDIA2019-026) (CHF45,000), Peking University Medicine Seed Fund for Interdisciplinary Research (BMU2018MX022) (¥40,000), and Peking University Third Hospital (No. Y71508-01) (¥400,000).Results: Twenty-six men and 13 women (mean age, 51.5 years) were included. Solitary plasmacytomas were located in the cervical, thoracic, and lumbar vertebrae in 16, 17, and 6 patients, respectively. The mean clinical follow-up period after treatment was 72 (range 12-216) months. Sixteen patients (41.0%) had significant reossification after radiotherapy, 21 (53.8%) showed mild reossification, and 2 (5.2%) had progressive bony destruction (after 7 and 23 months, respectively). There were no significant differences in age among the three groups (p=.127). At a mean follow-up of 37 (range 6-90) months after radiosurgery, 14 (35.8%) patients developed MM, including 9 patients who died at a mean duration of 55 (range 19-102) months. In the significant reossification group, only 1 patient (6.3%, 1 of 16) had MM progression 82 months after treatment (p=.044). In the mild reossification group, 56.5% (13 of 23) of patients had MM progression. The significant reossification rates of the radiotherapy dose groups of <40 Gy and ≥40 Gy were 35.7% and 44% (p=.614), respectively. In the univariate analysis, age ≥65 years (p<.001), tumor ≥5 cm (p=.009), Spinal Instability Neoplastic Score scores ≥11.5 (p=.040), radiotherapy (RT) combined with surgery (p<.001), and progression to MM (p=.007) were the independent prognostic factors for overall survival; whereas, age >44 years (p=.045) and RT combined with surgery (p<.001) were for multiple myeloma-free survival. In the multivariate analyses, age >65 years (p=.004) and progression to MM (p=.007) were the unfavorable independent factors for overall survival, whereas RT combined with surgery (p=.004) was the only factor for multiple myeloma-free survival.Conclusions: In patients with spinal SPB, 41.0% lesions showed significant reossification after radiotherapy. Patients with significant reossification had a better prognosis with less possibility of MM progression. Radiotherapy may be a safe and effective treatment choice for spinal SPB; more attention should be paid to reossification. [ABSTRACT FROM AUTHOR]