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Carella A, Spannella F, Morè S, Grifoni R, Settanni CR, Mandolesi A, Filosa A, Goteri G, Boccoli G, Fava G. A rare case of solitary plasmacytoma mimicking submucosal lesion of ascending colon: a case report and literature review. Front Oncol 2024; 14:1430745. [PMID: 39267849 PMCID: PMC11390380 DOI: 10.3389/fonc.2024.1430745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 08/02/2024] [Indexed: 09/15/2024] Open
Abstract
Solitary primary extraosseous plasmacytoma is a rare disease in the gastrointestinal tract, recently classified as an "exceptional" tumor of the colon site. The real incidence (one case/population/year) is unknown but reasonably less than 1/10,000,000 cases/year with very few descriptions in the literature. The rare cases described in the literature are often diagnosed after surgery for perforation and with predominant localization of the left colon. The main endoscopic presentation mimics colon carcinoma with ulcerated mass and obstructing lumen. In this paper, we report a rare case of isolated mass mimicking a submucosal lesion of the ascending colon diagnosed in an older female patient by colonoscopy. The patient was almost asymptomatic; she reported only a history of hematochezia without anemia. This mass was successfully treated by surgery and followed by hematological investigations, including bone marrow biopsy, specific laboratory tests, and CT/PET scan, which confirmed primary isolated plasmacytoma of the colon.
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Affiliation(s)
- Alessandra Carella
- Unit of Gastroenterology and Digestive Endoscopy, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
| | - Francesco Spannella
- Internal Medicine and Geriatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", Ancona, Italy
| | - Sonia Morè
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", Ancona, Italy
- Hematology Clinic, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| | - Riccardo Grifoni
- Department of General Surgery, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
| | - Carlo Romano Settanni
- Unit of Gastroenterology and Digestive Endoscopy, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
| | - Alessandra Mandolesi
- Anatomic Pathology, Department of Biomedical Sciences and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Alessandra Filosa
- Anatomic Pathology, Department of Biomedical Sciences and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Gaia Goteri
- Anatomic Pathology, Department of Biomedical Sciences and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Gianfranco Boccoli
- Department of General Surgery, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
| | - Giammarco Fava
- Unit of Gastroenterology and Digestive Endoscopy, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
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Stefanidis K, Yusuf G, Mulita F, Tsalikidis C, Mitsala A, Konstantelou E, Kotsopoulou M, Koletsis E, Pitiakoudis M, Dimopoulos P. Extraosseous Plasmacytomas: A Radiologist's Perspective-A Narrative Review of the Literature. Diagnostics (Basel) 2024; 14:1788. [PMID: 39202276 PMCID: PMC11353327 DOI: 10.3390/diagnostics14161788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 08/10/2024] [Accepted: 08/12/2024] [Indexed: 09/03/2024] Open
Abstract
Extraosseous plasmacytomas (EPs) are rare neoplasms originating from plasma cells, often associated with multiple myeloma. EPs are classified into three subtypes: extramedullary myeloma, solitary extramedullary plasmacytoma (SEP), and multiple solitary plasmacytomas. They can manifest in various anatomical sites, including the lung, mediastinum, breast, liver, pancreas, stomach, mesentery, kidney, small and large bowel, testis, and soft tissue. Despite their rarity, EPs present a diagnostic challenge due to their non-specific imaging appearances, which can mimic other neoplastic and inflammatory conditions. This review aims to describe the radiographic features of EPs in the chest, abdomen, and pelvis based on a thorough analysis of the existing literature. While imaging plays a crucial role in the detection and characterization of EPs, histological confirmation is necessary to differentiate them from other neoplastic entities. The review underscores the importance of considering EPs in the differential diagnosis, particularly in patients with a history of multiple myeloma. Understanding the imaging characteristics of EPs is essential for accurate diagnosis and appropriate management. Early imaging is crucial in these patients to exclude the possibility of EP, as timely diagnosis can significantly impact patient outcomes.
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Affiliation(s)
| | - Gibran Yusuf
- Radiology Department, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK;
| | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, 75000 Patras, Greece
| | - Christos Tsalikidis
- Second Department of Surgery, University General Hospital of Alexandroupolis, Democritus University of Thrace Medical School, 68100 Alexandroupolis, Greece; (C.T.); (A.M.)
| | - Athanasia Mitsala
- Second Department of Surgery, University General Hospital of Alexandroupolis, Democritus University of Thrace Medical School, 68100 Alexandroupolis, Greece; (C.T.); (A.M.)
| | | | - Maria Kotsopoulou
- Haematology Department, Metaxa Cancer Hospital, 18537 Piraeus, Greece;
| | - Efstratios Koletsis
- Department of Cardiothoracic Surgery, General University Hospital of Patras, 75000 Patras, Greece;
| | - Michail Pitiakoudis
- Second Department of Surgery, University General Hospital of Alexandroupolis, Democritus University of Thrace Medical School, 68100 Alexandroupolis, Greece; (C.T.); (A.M.)
| | - Platon Dimopoulos
- Department of Radiology, General University of Patras, 61000 Patras, Greece;
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Alfar R, Kamal N, Abdel Razeq R, Omari Z, Bater R, Sharaf B. A Durable Response of Primary Advanced Colonic Plasmacytoma Using a Combination of Surgical Resection and Adjuvant Bortezomib: A Case Report and Literature Review. Onco Targets Ther 2022; 15:1347-1354. [DOI: 10.2147/ott.s372534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/25/2022] [Indexed: 11/09/2022] Open
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Wang KW, Xiao N. Intestinal perforation with abdominal abscess caused by extramedullary plasmacytoma of small intestine: A case report and literature review. World J Gastrointest Surg 2022; 14:611-620. [PMID: 35979418 PMCID: PMC9258233 DOI: 10.4240/wjgs.v14.i6.611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/26/2022] [Accepted: 05/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Extramedullary plasmacytoma (EMP) of the gastrointestinal tract is an extremely rare disease. Clinical manifestations of EMPs are varied and depend on the location and progression of the tumor.
CASE SUMMARY Here, we firstly report a case of intestinal perforation with abdominal abscess caused by EMP of the small intestine in a 55-year-old female patient. The patient received emergency surgery immediately after the necessary preoperative procedures. During the operation, EMP was found to have caused the perforation of the small intestine and the formation of multiple abscesses in the abdominal cavity. Partial resection of the small intestine with peritoneal irrigation and drainage was performed. EMP was finally confirmed by postoperative histopathology and laboratory tests. Additionally, we performed a literature review of gastrointestinal EMP to obtain a deeper understanding of this disease.
CONCLUSION EMP of the small intestine may have spontaneous perforation, which requires emergency surgery. Surgical resection can obtain good therapeutic effects.
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Affiliation(s)
- Ke-Wei Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Nan Xiao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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Rene CG, Achiam MP, Salomo M, Penninga L. Extramedullary relapse in a patient with multiple myeloma: a rare cause of gastrointestinal perforation and massive bleeding. BMJ Case Rep 2021; 14:e243663. [PMID: 34794974 PMCID: PMC8603271 DOI: 10.1136/bcr-2021-243663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 11/03/2022] Open
Abstract
Multiple myeloma (MM) patients live longer due to more effective treatment, and we now see previously uncommon manifestations of MM, like extramedullary disease. We present a case of a 74-year-old man known with MM that relapsed with extramedullary manifestations at different locations. One of them as a gastric plasmacytoma (GP). He was successfully treated with chemoradiotherapy (Daratumumab, Bortezomib and Dexamethasone), which resulted in clinical response for 8 months, confirmed by biopsy and histopathology. Perforation of the GP occurred, and he underwent partial gastrectomy (Billroth II gastrojejunostomy). The patient's disease progressed again 5 months after surgery, and he did not want any additional treatment. He accepted palliative care and died 10 months after the operation. A lack of knowledge about the characteristics and treatment of extramedullary MM exists, and prospective studies to investigate incidence, prognosis and treatment for extramedullary MM are needed for improving the poor prognosis of this manifestation.
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Affiliation(s)
| | | | - Morten Salomo
- Department of Haematology, Rigshospitalet, Copenhagen, Denmark
| | - Luit Penninga
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen, Denmark
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Zhang QY, Li TC, Lin J, He LL, Liu XY. Coexistence of cervical extramedullary plasmacytoma and squamous cell carcinoma: A case report. World J Clin Cases 2021; 9:7110-7116. [PMID: 34540966 PMCID: PMC8409213 DOI: 10.12998/wjcc.v9.i24.7110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/25/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Extramedullary plasmacytoma (EMP), a variant form of myeloma, is a rare solid plasma cell tumor that originates from the bone marrow hematopoietic tissue and accounts for about 3% of all plasma cell tumors. EMP can affect various tissues and organs, about 90% of which is found in the head and neck. However, EMP in the reproductive organs is rare, and is difficult to be distinguished from other primary or metastatic genital tumors according to clinical symptoms and imaging findings.
CASE SUMMARY Herein, we report a case with coexistence of EMP and squamous cell carcinoma in the cervix. The first histopathological report of neoplasms on the surface of the cervix and vagina showed an EMP. Both ultrasound and pelvic enhanced magnetic resonance imaging (MRI) indicated that there was a tumor in the cervix. Thus, another cervical biopsy and pathological examination were performed, which indicated EMP combined with squamous cell carcinoma. Then, the patient underwent extensive total hysterectomy (type C1) + systemic lymph node dissection and received 25 external pelvic irradiations with a dose of 50 Gy following surgery. During 2-year follow-up, no recurrence was reported.
CONCLUSION In conclusion, EMP involving the reproductive system is relatively rare. In this case, MRI, B-ultrasound, and cervical canal scraping were used to further determine the diagnosis of EMP combined with squamous cell carcinoma. The patient had improved prognosis after appropriate treatments.
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Affiliation(s)
- Qing-Yun Zhang
- Department of Gynecology and Obstetrics, The First People’s Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Ting-Chao Li
- Pathology Department, The First People’s Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Jiang Lin
- Imaging Department, The First People’s Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Lian-Li He
- Department of Gynecology and Obstetrics, The First People’s Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Xiao-Yun Liu
- Department of Gynecology and Obstetrics, The First People’s Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
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