The solitary plasmacytoma sp is characterized by a localized accumulation of neoplastic monoclonal plasma cells without a proof of a systemic plasma cell proliferative disorder. Additional information is now available on the role of serum free light chains and pet scanning. This may possibly be combined with a stem cell transplant. What was initially felt to be an incidental osteosclerotic. They may involve any bone, but they have a predisposition for the red marrowcontaining axial skeleton. Diagnosis and management of solitary plasmacytoma of bone. From 1995 to 2008, 18 patients were treated with local radiotherapy. Pdf diagnosis, treatment, and response assessment in. Fifteen patients with known pc underwent pet using f18 fluorodeoxyglucose fdgpet. This infosheet explains what a solitary plasmacytoma is, what causes one, what the signs and symptoms are, what diagnosis involves and how they are treated. Plasma cell neoplasms account for approximately 1% to 2% of human malignancies and occur at a rate of about 3.
Diagnosis, treatment, and response assessment in solitary. Investigations for multiple myeloma, including bone marrow aspiration and biopsy, were negative. The usual dose of 40 gy to 50 gy given for about four weeks produces local response rate of. Solitary plasmacytoma sp of the bone is a rare plasmacell neoplasm. They are solitary lesions, and are most often located in the head and neck region, mainly in the upper aerodigestive tract, but may also occur in the gastrointestinal tract, urinary bladder, central. For spb and extramedullary plasmacytoma the distinction is the presence of only one. A solitary plasmacytoma is a single cancer site that may involve the bone osseous or other tissues extraosseous or extramedullary. A standard uptake value suv was measured for the solitary plasmacytoma and analyzed for correlation to the mm diagnosis. Solitary plasmacytoma is an uncommon type of plasma cell dyscrasia, which might occur in bone or soft tissue. Solitary plasmacytoma of bone and asymptomatic multiple.
Since the previous guideline several new articles on prognostic factors, treatment and outcome in patients with solitary plasmacytoma of bone have been published. Solitary plasmacytoma sp is a plasma cell disorder characterized by localized accumulation of neoplastic monoclonal plasma cells in bone, or in soft tissues with no skeletal component, without any evidence of systemic involvement as demonstrated by the lack of clonal plasma cells in the bone marrow and absence of features of endorgan damage. Unusual patterns of solitary sacral plasmacytoma charles f. Solitary bone plasmacytoma is one of the two subgroups of plasmacytoma, the.
Plasmacytoma is a more benign condition than multiple myeloma, although it can develop into multiple myeloma. A plasmacytoma is a discrete, solitary mass of neoplastic monoclonal plasma cells in either bone or soft tissue extramedullary. Find out about solitary myeloma symptoms, diagnosis and treatment. Solitary plasmacytoma of bone and soft tissues sciencedirect. Trial of immunomodulatory therapy in high risk solitary bone plasmacytoma idris the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. The aim of treatment is to direct enough radiation to the tumour to kill as many of the plasmacytoma cells as possible, while minimising damage to nearby tissues. I was diagnosed in 2007 with singular extramedullary plasmacytoma located in my mouth, throat and airways. The follow up consisted of blood and urine tests every third month and plain xrays. Radiation therapy for treating solitary plasmacytoma. Staging is an attempt to find out the size of the tumor, whether the disease has spread, and, if so, to what parts of the body. Solitary bone and extramedullary plasmacytomas are rare plasma cell proliferative disorders. Plasmacytoma is a form of cancer derived from neoplastic monoclonal plasma cells, and it can be classified into two groups depending on its location. Rabinowitz1 solitary plasmacytomas are usually lytic and expansile and present in the ilium or long bones because of local pain or swelling 1. Listing a study does not mean it has been evaluated by the u.
Wed like to understand how you use our websites in order to improve them. Between 1956 and 1978, nine patients with solitary plasmacytoma of bone spb and seven with extramedullary plasmacytoma emp were treated at the university of washington hospital and swedish tumor institute. In patients with either solitary plasmacytoma of bone or asymptomatic mm, systemic treatment should be deferred until there is evidence of disease progression. Solitary plasmacytoma multiple myeloma texas oncology. If the doctor diagnoses plasmacytoma, he or she will need to determine the stage, or extent, of the disease in order to plan the best treatment. It is an infrequent form of plasma cell neoplasm and represents 5% to 10% of all plasma cell neoplasms according to the literature 15. Solitary bone plasmacytoma and extramedullary plasmacytoma. Transsphenoidal treatment of nonneoplastic intra sellar cysts.
Solitary bone plasmacytomas is an uncommon plasma cell tumor which is localized to bone. Radiation therapy for solitary plasmacytoma and multiple. The radiation is similar to an xray but more powerful. The common presentation of sbp is in the axial skeleton, whereas the extramedullary plasmacytoma. Extramedullary plasmacytoma, plasmacytoma of the lung, solitary plasmacytoma. Solitary intracranial plasmacytoma pdf free download. Why some patients develop multiple myeloma and others a single plasmacytoma is not understood, but might be related to differences in cellular adhesion molecules or chemokine receptor. The most common of these is spb, accounting for 35% of all plasma cell. Guidelines on the diagnosis and management of solitary plasmacytoma of bone. 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. The conventional treatment for the plasmacytoma of the bone is radiation therapy. Biopsy confirmation of a monoclonal plasma cell infiltration from a single site is required for diagnosis. Solitary plasmacytoma, extramedullary plasmacytoma, myeloma, plasma cell dyscrasia.
Solitary plasmacytoma of the bone can sometimes be cured with radiation therapy or surgery to destroy or remove the tumor. Softtissue or nonosseous extramedullary plasmacytoma emp solitary bone plasmacytoma sbp multifocal form of multiple myeloma multiple myeloma plasmablastic sarcoma t. Solitary or extramedullary plasmacytoma memorial sloan. A 51yearold man presented with a 1year history of polyneuropathy necessitating the use of a wheelchair.
Initial diagnosis was idiopathic chronic inflammatory demyelinating polyneuropathy cidp and associated monoclonal gammopathy. Solitary bone plasmacytoma radiology reference article. Patients with extramedullary plasmacytomas and osteosclerotic lesions were. The most common treatment for both for both types of solitary plasmacytoma is radiotherapy. Standard treatment for solitary plasmacytoma is irradiation to the entire lesion with appropriate margins. I had radiation treatment to my throat along with chemo to get the cancer in the other areas. Ct scan of the plasmacytoma should be obtained prior to radiation therapy. Solitary plasmacytoma of bone and soft tissue sciencedirect. Solitary plasmacytoma sp is characterized by a mass of neoplastic monoclonal plasma cells in either bone sbp or soft tissue without evidence of systemic disease attributing to myeloma. Immunoglobulin free light chains and solitary plasmacytoma.
Diagnosis of a solitary plasmacytoma requires a very thorough evaluation. Pdf solitary bone plasmacytoma sbp is a rare entity characterized by localized proliferation of monoclonal plasma cells primarily occurring. Surgery was performed to all patients with spb in combination with radiation therapy or chemotherapy, or both. They didnt go for a new biopsy at the site of the tumour. In radiation therapy, there is focusing of radiation on the solitary plasmacytoma to destroy the abnormal cancerous cells. Solitary plasmacytomas represent approximately 5% of all patients with myeloma. Currently, radiation therapy remains the primary choice of treatment for spb, as plasmacytoma is a radiosensitive tumor. There are no conclusive data in the literature on the optimal radiation therapy rt dose in sp. Positron emission tomography pet for staging of solitary. Solitary plasmacytomas are highly radiosensitive lesions. The myeloma infoline and ask the nurse services are fully staffed and are here to answer your questions and concerns and be a listening ear. Soft tissue solitary plasmacytoma or extramedullary plasmacytoma is less. Radiation therapy is the commonly used treatment for both the types of solitary plasmacytoma, as solitary plasmacytomas are localized and there is only one tumor present. Trial of immunomodulatory therapy in high risk solitary.
Diagnosis, treatment, and response assessment in solitary plasmacytoma. Radiation therapy, radical extensive surgery, or a combination of both is recommended as primary treatment. Solitary plasmacytoma symptoms, diagnosis, treatments and. Solitary plasmacytoma in the mandible resembling an. This study was undertaken to investigate the clinical value in staging patients with plasmacytoma pc using positron emission tomography pet. However, 70 percent of people with solitary plasmacytoma eventually develop multiple myeloma. Such patients usually become free of symptoms after local radiotherapy. Plasmacytoma is a plasma cell dyscrasia in which a plasma cell tumour grows within soft tissue. Solitary extramedullary plasmacytomas sep, solitary extraosseous plasmacytoma are plasma cell tumors that arise outside of the bone marrow. This shows invasion of the bone or tissue by monoclonal identical plasma cells see cutaneous plasmacytoma pathology. Plasmacytoma is diagnosed by a tissue biopsy or bone marrow biopsy. These guidelines were developed by a working group of. In this retrospective analysis, we report the university heidelberg experience in the treatment of solitary plasmacytoma.
Solitary plasmacytoma of bone spb, also called osseous plasmacytoma is a localized tumor in the bone comprised of a single clone of plasma cells in the absence of other features of mm ie, anemia, hypercalcemia, renal insufficiency, or multiple lytic bone lesions. Fdgpet was done for staging in 11 patients and for restaging in 4 patients. Plasmocytome solitaire pulmonaire traite par radiotherapie. In 2011 spring time i was diagnosed with a solitary plasmacytoma in vertebra l1. Rathkes cleft cystintracranial plasmacytoma case reports 11. Localized plasmacytoma are less common than multiple myeloma and can occur as an extra osseous form and solitary bone neoplasm. Solitary plasmacytoma sp is the clinical condition characterized by the localized proliferation of clonal plasma cells. Data from 206 patients with bone sp without evidence of multiple myeloma mm. A type of cancer from plasma cells where the plasma cells multiply uncontrollably. Solitary intracranial plasmacytomas sips are rare tumours that may be mistaken radiologically for meningiomas. Original article the outcome and analysis of different. Solitary plasmacytomas most frequently occur in bone plasmacytoma of bone, but can also be found outside bone in soft tissues extramedullary plasmacytoma.
Plasmacytoma is a plasma cell dyscrasia in which a plasma cell tumour grows within soft tissue or within the axial skeleton the international myeloma working group lists three types. Plasma cell leukaemia is significantly more aggressive than myeloma and usually requires more intensive treatment. They then need additional treatment, such as chemotherapy. Diagnosis and management of solitary extramedullary. Liebross et al3 reported that of 1,354 patients treated for plasma cell neoplasms at the m.
Risk of progression of solitary bone plasmacytoma to myeloma using a risk stratification model that incorporates the serum free light chain flc ratio measured at baseline a or 1 to 2 years following diagnosis b and the persistence of serum monoclonal protein 1 to 2 years following diagnosis. Their diagnosis is based on histologic confirmation of monoclonal plasma cell infiltration of a single disease site and on the exclusion of systemic myeloma. The definition of sp has been evolving as a result of improvement in imaging technology as well as the availability of more sensitive techniques that can detect small populations of clonal plasma cells in the bone marrow. Radical radiotherapy comprising of 4050 gy has shown 80% of local disease control. The treatment was orthopedic surgery and 25 rounds of radiation. Solitary plasmacytoma is usually considered to be the diagnosis in cases where only one plasma cell tumour is found. Eleven patients had pc of bone, and 4 patients had. Guidelines on the diagnosis and management of solitary. In patients with mm without symptoms, the diagnosis is made on the basis of screening laboratory tests. If the cancer is located in only one part of the body it is called a solitary plasmacytoma and if there are multiple sites it is called a multiple myeloma. Treatment recommendations are often limited to prior case successes. Therefore, in this large retrospective study, we wanted to assess the outcome, prognostic factors, and the optimal rt dose in patients with sp.