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Chadli S, Oudrhiri MY, Maamar M, Boutarbouch M, Khibri H, Haidouri S, Messaoud O, El-Aoufir O, Melhaoui A, Ammouri W, Ouahabi A, Harmouche H, Adnaoui M, Tazi Mezalek Z. Sphenoid plasmacytoma as initial presentation of multiple myeloma-case report. J Surg Case Rep 2024; 2024:rjae199. [PMID: 38572279 PMCID: PMC10987209 DOI: 10.1093/jscr/rjae199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
Plasmacytoma is a rare plasma cell neoplasm. Whether solitary or associated with multiple myeloma (MM), it rarely involves the skull base, particularly the sphenoid bone. We present a unique case of sphenoid bone plasmacytoma secondary to MM, highlighting diagnostic and therapeutic challenges. A 56-year-old female presented with headaches, vomiting, epistaxis, and cranial nerve deficits. Cerebral imaging revealed a 65-mm tumor infiltrating the sphenoid bone and adjacent structures. Subtotal resection was performed using an endoscopic nasal approach. Histopathology revealed plasmacytoma, and diagnostic workup confirmed MM. By the end of biological exploration, relapse of the sphenoid plasmacytoma was observed, and the patient was successfully treated with radiotherapy, immunochemotherapy, and autologous stem cell transplantation. After 18-month follow-up, sustained complete remission was confirmed. Although rare, the diagnosis of plasmacytoma should be considered in cases of skull base tumors. This localization is highly predictive of MM, warranting comprehensive investigations to initiate prompt and adequate management.
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Affiliation(s)
- Sarra Chadli
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Mohammed Y Oudrhiri
- Neurosurgery HSR, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Mouna Maamar
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Mahjouba Boutarbouch
- Neurosurgery HSR, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Hajar Khibri
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Soukaina Haidouri
- Clinical Hematology, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Ola Messaoud
- Radiology, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Omar El-Aoufir
- Radiology, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Adyl Melhaoui
- Neurosurgery HSR, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Wafaa Ammouri
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Abdessamad Ouahabi
- Neurosurgery HSR, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Hicham Harmouche
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Mohammed Adnaoui
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
| | - Zoubida Tazi Mezalek
- Internal Medicine, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
- Clinical Hematology, Ibn Sina University Hospital, Mohammed V
University, 10100 Rabat, Morocco
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Abduh MS. An overview of multiple myeloma: A monoclonal plasma cell malignancy's diagnosis, management, and treatment modalities. Saudi J Biol Sci 2024; 31:103920. [PMID: 38283805 PMCID: PMC10818257 DOI: 10.1016/j.sjbs.2023.103920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024] Open
Abstract
Multiple Myeloma (MM) is a plasma cell cancer with high mortality and morbidity rates. Its incidence rate has increased by 143% since 1975. Adipokines, cytokines, chemokines, and genetic variations influence the development and progression of MM. Chromosomal translocations cause mutations associated with MM. The pathogenesis of MM is complicated by novel issues like miRNAs, RANKL, Wnt/DKK1, Wnt, and OPG. Conventional diagnosis methods include bone marrow biopsy, sPEP or uPEP, sIFE and uIFE, and sFLC assay, along with advanced techniques such as FISH, SNPA, and gene expression technologies. A novel therapeutic strategy has been developed recently. Chemotherapy, hematopoietic stem cell transplantation, and a variety of drug classes in combination are used to treat patients with high-risk diseases. Alkylating agents, PIs, and IMiDs have all been developed as effective treatment options for MM in recent years. This review overviews the current recommendations for managing MGUS, SMM, MM, SP and NSMM and discusses practices in diagnosing and treating MM.
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Affiliation(s)
- Maisa Siddiq Abduh
- Immune Responses in Different Diseases Research Group, Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
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3
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Jaafar NA, Hussain FA, Mat Lazim N. Successful Treatment of Extraosseous Plasmacytoma of the Oropharynx with Cervical Lymph Node Involvement. Indian J Otolaryngol Head Neck Surg 2024; 76:1220-1223. [PMID: 38440494 PMCID: PMC10908905 DOI: 10.1007/s12070-023-04228-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/07/2023] [Indexed: 03/06/2024] Open
Abstract
Extraosseous plasmacytoma, a rare plasma cell neoplasm, was observed in a 52-year-old male with uncommon presentation in the oropharynx with cervical lymph node involvement. The patient presented with dysphonia and left neck swelling. This case report primarily focuses on the management, resulting in a successful treatment through radiotherapy.
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Affiliation(s)
- Nurul Amilin Jaafar
- Department of Otorhinolaryngology-Head Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
| | - Faezahtul Arbaeyah Hussain
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
| | - Norhafiza Mat Lazim
- Department of Otorhinolaryngology-Head Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
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4
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Kamboj V, Shenoy S V, Sriperumbudur S, Parvathareddy N. Solitary Bone Plasmacytoma Mimicking Oral Cavity Neoplasm - A Rare Case. Indian J Otolaryngol Head Neck Surg 2023; 75:2809-2813. [PMID: 38027534 PMCID: PMC10645874 DOI: 10.1007/s12070-023-03875-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/07/2023] [Indexed: 12/01/2023] Open
Abstract
Plasmacytomas are localized monoclonal plasma cell lesions with no evidence of systemic involvement which are divided into solitary bone plasmacytoma (SBP) and extra-medullary plasmacytoma (EMP). The diagnosis of plasmacytomas (PCM) in the oral regions is challenging given the atypical clinical manifestations and low frequency. Here, we report an extremely rare case of plasmacytoma in an elderly male which initially appeared to be arising from the left buccal mucosa on clinical examination but after radiological imaging and intra-operative findings, the epicentre was found to be in the left infratemporal fossa (ITF). The patient underwent en-bloc compartment resection with high clearance of the ITF which proved to be an effective management strategy. It is crucial for the head and neck surgeon to be aware of the solitary bone plasmacytoma in the oral and maxillofacial region in order to identify it early and provide these patients with the best care possible before complications arise.
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Affiliation(s)
- Vikrant Kamboj
- Department of Otorhinolaryngology and Head and neck Surgery, Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, India
| | - Vijendra Shenoy S
- Department of Otorhinolaryngology and Head and neck Surgery, Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, India
| | - Susmita Sriperumbudur
- Department of Otorhinolaryngology and Head and neck Surgery, Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, India
| | - Navya Parvathareddy
- Department of Otorhinolaryngology and Head and neck Surgery, Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, India
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5
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Kizhakkayil Tency N, Camarena JA, Roy A, Pradeep M. A Case Report of Plasmacytoma in a 28-Year-Old Patient: Bridging the Age Gap in a Rare Presentation. Cureus 2023; 15:e47671. [PMID: 38022027 PMCID: PMC10672403 DOI: 10.7759/cureus.47671] [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] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Plasmacytoma, an uncommon malignancy originating from plasma cells, predominantly manifests in the elderly demographic. However, its incidence among young adults remains infrequent. Herein, we present a case involving a 28-year-old young adult diagnosed with solitary bone plasmacytoma. The patient presented with acute exacerbation of chronic lower back pain of two years, which, upon hospitalization, was attributed to a lumbar spine compression fracture. Comprehensive blood analysis, imaging studies, and pathology assessments suggested the likelihood of solitary plasmacytoma, devoid of indicators characteristic of multiple myeloma (MM). The patient was given symptomatic treatment and underwent surgical spine decompression, followed by the commencement of radiation therapy to address the malignancy. Subsequent to radiotherapeutic intervention, a noteworthy amelioration in pain and overall condition was observed. This case report assumes importance due to the insight it provides into the natural progression of solitary plasmacytoma. Patients with pathological fractures warrant thorough assessment for solitary plasmacytoma, necessitating vigilant monitoring for its potential evolution into MM. This case serves as a pertinent illustration of the need to expand our existing knowledge of solitary bone plasmacytoma, moving beyond the conventional notion that it predominantly afflicts the elderly population.
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Affiliation(s)
| | - Julieanna A Camarena
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, USA
| | - Archa Roy
- Department of Internal Medicine, Government T D Medical College, Alappuzha, IND
| | - Mini Pradeep
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, USA
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Lamb MM, Zeatoun A, Stack TJ, Kim S, Albastoni S, Singer B, Klatt-Cromwell C, Senior BA, Kimple AJ, Thorp BD. Plasmacytoma of the Head and Neck: Case Series and Review of the Literature. ORL J Otorhinolaryngol Relat Spec 2023; 85:231-237. [PMID: 37364541 DOI: 10.1159/000530946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/24/2023] [Indexed: 06/28/2023]
Abstract
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.
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Affiliation(s)
- Meredith M Lamb
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA,
| | - Abdullah Zeatoun
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Taylor J Stack
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sulgi Kim
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sara Albastoni
- Department of Pathology & Laboratory Medicine at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Bart Singer
- Department of Pathology & Laboratory Medicine at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Cristine Klatt-Cromwell
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brent A Senior
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Adam J Kimple
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian D Thorp
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
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7
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Guedes A, Becker RG, Teixeira LEM. Multiple Myeloma (Part 1) - Update on Epidemiology, Diagnostic Criteria, Systemic Treatment and Prognosis. Rev Bras Ortop 2023; 58:361-367. [PMID: 37396092 PMCID: PMC10310414 DOI: 10.1055/s-0043-1770149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/12/2022] [Indexed: 07/04/2023] Open
Abstract
Multiple myeloma (MM) is a hematological malignancy characterized by unregulated and clonal proliferation of plasma cells in the bone marrow; these cells produce and secrete an anomalous monoclonal immunoglobulin, or a fragment of this, called M protein. The clinical manifestations of MM result from the proliferation of these plasmocytes, the excessive production of monoclonal immunoglobulin and the suppression of normal humoral immunity, leading to hypercalcemia, bone destruction, renal failure, suppression of hematopoiesis and humoral immunity, increasing the risk for the development of infections. The increase in life expectancy of the world population led to a concomitant increase in the prevalence of MM, a pathology that usually affects the elderly population. The aim of this review is to update the reader on epidemiology, diagnostic criteria, differential diagnosis with other monoclonal gammopathies, systemic treatment and prognosis of MM.
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Affiliation(s)
- Alex Guedes
- Grupo de Oncologia Ortopédica, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brasil
- Serviço de Trauma Ortopédico, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul
- Departamento do Aparelho Locomotor, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Luiz Eduardo Moreira Teixeira
- Departamento do Aparelho Locomotor da Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Albandak M, Mikkawi A, Ayasa LA, Ansara Y, Janajri M. Solitary Plasmacytoma in the Calcaneus. Cureus 2023; 15:e37637. [PMID: 37200639 PMCID: PMC10187489 DOI: 10.7759/cureus.37637] [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] [Accepted: 04/16/2023] [Indexed: 05/20/2023] Open
Abstract
Solitary plasmacytomas (SPs) are tumors characterized by local monoclonal plasma cell proliferation, presenting without systemic manifestations. It mainly affects the axial skeleton, with calcaneal involvement being extremely rare. We report a case of a 48-year-old patient with a history of gunshot injury to his foot who presented with worsening heel pain and a calcaneal cyst. Biopsy revealed plasmacytoma, and subsequent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan further supported the diagnosis of solitary plasmacytoma of the bone (SPB). Management included lesion excision, bone cement placement, and radiotherapy. However, due to recurrent osteomyelitis following cement placement, the patient eventually required total calcanectomy. SPB usually affects older adults, and developing the disease at a young age and in the calcaneus is exceedingly uncommon. Trauma is implicated as a possible inciting trigger in the pathogenesis of SPB without a clear association. This case highlights the importance of developing our current understanding of the clinical presentation and manifestations of SPB, beyond the conventional assumption that it only affects the axial skeleton of older individuals.
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Affiliation(s)
| | - Aya Mikkawi
- Internal Medicine, An-Najah National University, Nablus, PSE
| | - Laith A Ayasa
- Internal Medicine, Al-Quds University, Jerusalem, PSE
| | - Yousef Ansara
- Internal Medicine, Al-Quds University, Jerusalem, PSE
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9
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Yang XW, Zhou GC, Long ZS, Gong FP, Chen G. Solitary bone plasmacytoma of the tibia presenting as chronic osteomyelitis: A rare case report and literature review. Medicine (Baltimore) 2023; 102:e33307. [PMID: 36961183 PMCID: PMC10036042 DOI: 10.1097/md.0000000000033307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 02/27/2023] [Indexed: 03/25/2023] Open
Abstract
RATIONALE Plasmacytoma is a rare plasma cell dyscrasia that grows within the axial skeleton or soft tissue structures as solitary or multiple masses. The primary types are solitary plasmacytoma, including solitary bone plasmacytoma (SBP) and solitary extramedullary plasmacytoma, and multiple solitary plasmacytomas. SBP is characterized by localized proliferation of monoclonal plasma cells and is rare. However, SBP with chronic osteomyelitis is even rarer. PATIENT CONCERNS A 47-year-old man previously diagnosed with chronic osteomyelitis presented with repeated discharge and ulceration in the front of his right tibia. DIAGNOSIS, INTERVENTIONS AND OUTCOMES Lower extremity magnetic resonance imaging (MRI) and computed tomography (CT) examinations showed dead bone formation and surrounding inflammatory edema. Thus, the patient underwent dead bone excision and fenestration of the bone marrow cavity. The histopathologic examination results indicated plasmacytoma. Therefore, we administered radiotherapy with satisfactory results. LESSONS Physicians should pay close attention to chronic osteomyelitis because it may be accompanied by plasmacytoma. Postoperative pathological and immunohistochemical examinations are crucial, and surgical resection of the lesion and local radiotherapy are effective treatment methods.
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Affiliation(s)
- Xiao-Wei Yang
- Department of Orthopedics, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Gui-Chao Zhou
- Department of Orthopedics, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Zhi-Sheng Long
- Department of Orthopedics, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Fei-Peng Gong
- Department of Orthopedics, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Gang Chen
- Department of Orthopedics, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
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Wu Y, Wei J, Chen S, Liu X, Cao J. A new prediction model for overall survival of elderly patients with solitary bone plasmacytoma: A population-based study. Front Public Health 2022; 10:954816. [PMID: 36176534 PMCID: PMC9513445 DOI: 10.3389/fpubh.2022.954816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background Comprehensive studies on the prognosis of solitary bone plasmacytoma (SPB) are lacking, especially in elderly patients with SPB. This study aims to establish a novel nomogram and risk stratification system to predict the overall survival (OS) of elderly patients with SPB. Methods The data of elderly patients with SPB from 2000 to 2017 were identified in the SEER database. SPB patients were randomly assigned to the training set (n = 825) and validation set (n = 354). The Cox regression analysis was used to determine the independent risk factors for OS in elderly SPB patients. The nomogram was established and assessed by the area under the receiver operating curve (AUC), the consistency index (C-index), and the calibration plot. Patients were divided into low-, medium-, and high-risk groups based on the score of the nomogram. The Kaplan-Meier (K-M) curve was used to verify the differences in overall survival among the three groups. Result A total of 1,179 elderly patients with SPB were included in the study. Age at diagnosis, prior cancer before SPB, marital status, radiotherapy, and chemotherapy were independent risk factors of OS. The AUC of the 3, 5, and 8-year OS in the training and validation sets were between 0.707 and 0.860. The C-index and calibration plot also indicated that the nomogram has great predictive accuracy and robustness. After risk stratification, patients in the high-risk group had the worst OS. Conclusion A novel nomogram was built to predict the OS of elderly patients with SPB. It will help clinicians formulate more reasonable and personalized treatment strategies.
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Affiliation(s)
- Yingying Wu
- Department of Blood Transfusion, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jiemin Wei
- Department of Hematology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shaomei Chen
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaozhu Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Xiaozhu Liu
| | - Junyi Cao
- Department of Medical Quality Control, The First People's Hospital of Zigong City, Zigong, China,Junyi Cao
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Bethel N, Asrar H, Dacosta J, Savopoulos A, Shaaban H. A Rare Case of Solitary Plasmacytoma Arising From the Sternum. Cureus 2022; 14:e23819. [PMID: 35530885 PMCID: PMC9067889 DOI: 10.7759/cureus.23819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 11/29/2022] Open
Abstract
Solitary plasmacytoma (SP) is characterized by an accumulation of neoplastic monoclonal plasma cells in a localized fashion, without evidence of multiple myeloma. It makes up <5% of all plasma cell neoplasms and is typically found in regions like the pelvis, ribs, vertebra, and spine. SP is classified into extramedullary plasmacytoma (EMP), which primarily affects soft tissues, and solitary bone plasmacytoma (SBP), which primarily affects the pelvis, ribs, vertebrae, and spine. We report a case of a 66-year-old man with sternal plasmacytoma presenting as chest pain. He was treated with radiation therapy. Here, we aim to describe the clinical features, diagnostic methods, treatment, and potential outcome in a patient with SBP.
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12
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Feng G, Shu WB, Li AB. Prognostic Nomogram for Predicting Overall Survival of Solitary Bone Plasmacytoma Patients: A Large Population-Based Study. Int J Gen Med 2021; 14:8621-8630. [PMID: 34849007 PMCID: PMC8627270 DOI: 10.2147/ijgm.s335976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background The aim of the study was to develop a nomogram to predict the overall survival (OS) of patients with solitary plasmacytoma of bone (SBP). Materials and Methods Patients diagnosed with SBP between 1993 and 2012 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. All eligible patients were randomly allocated to the training sets and the validation sets. The nomogram was developed with the training set and validated with the validation set using the concordance index (C-index), calibration plots, and decision curve analyses (DCA). Results Age, marital status, tumor grade, treatment were independent prognostic indicators for OS (P<0.05) and were integrated to construct the nomogram. C-indexes for OS prediction in the training and validation sets were 0.78 and 0.73, respectively. The calibration plots demonstrated good consistency between the predicted and actual survival. DCA demonstrated that the new model has great benefits. In the total cohort, the median OS of patients in the low- and high-risk groups were 12.17 (95% CI 11.92–12.42) and 3.92 (95% CI 2.83–5.01) years, respectively. Conclusion The nomogram showed excellent applicability and accuracy, which could be a reliable tool for predicting OS in SBP patients.
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Affiliation(s)
- Gong Feng
- School of Medicine, Ningbo University, Ningbo, Zhejiang, 315211, People's Republic of China
| | - Wu-Bin Shu
- Department of Orthopedics, Ningbo Yinzhou Second Hospital, Ningbo, 315100, Zhejiang, People's Republic of China
| | - A-Bing Li
- Department of Orthopedics, Ningbo Yinzhou Second Hospital, Ningbo, 315100, Zhejiang, People's Republic of China
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13
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Heider M, Nickel K, Högner M, Bassermann F. Multiple Myeloma: Molecular Pathogenesis and Disease Evolution. Oncol Res Treat 2021; 44:672-681. [PMID: 34749378 DOI: 10.1159/000520312] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/12/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Multiple myeloma is the second most common hematologic malignancy, which to date remains incurable despite advances in treatment strategies including the use of novel substances such as proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies. SUMMARY The bone marrow-based disease is preceded by the 2 sequential premalignant conditions: monoclonal gammo-pathy of undetermined significance and smoldering myeloma. Plasma cell leukemia and extramedullary disease occur, when malignant clones lose their dependency on the bone marrow. Key genetic features of these plasma cell dyscrasias include chromosomal aberrations such as translocations and hyperdiploidy, which occur during error-prone physiologic processes in B-cell development. Next-generation sequencing studies have identified mutations in major oncogenic pathways and tumor suppressors, which contribute to the pathogenesis of multiple myeloma and have revealed insights into the clonal evolution of the disease, particularly along different lines of therapy. More recently, the importance of epigenetic alterations and the role of the bone marrow microenvironment, including immune and osteogenic cells, have become evident. Key Messages: We herein review the current knowledge of the pathogenesis of multiple myeloma, which is crucial for the development of novel targeted therapeutic strategies. These can contribute to the endeavor to make multiple myeloma a curable disease.
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Affiliation(s)
- Michael Heider
- Department of Medicine III, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TranslaTUM, Center for Translational Cancer Research, Technical University of Munich, Munich, Germany
| | - Katharina Nickel
- Department of Medicine III, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Marion Högner
- Department of Medicine III, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Florian Bassermann
- Department of Medicine III, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TranslaTUM, Center for Translational Cancer Research, Technical University of Munich, Munich, Germany
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14
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Prabhu RM, Keny SA. Rare Case of a Solitary Bone Plasmacytoma of the Proximal Femur Managed with Surgery and Adjuvant Chemotherapy: A Case Report. J Orthop Case Rep 2021; 11:24-28. [PMID: 34557433 PMCID: PMC8422016 DOI: 10.13107/jocr.2021.v11.i05.2190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Solitary plasmacytoma of the bone is a rare neoplasm characterized by proliferation of neoplastic plasma cells in the bone in the absence of systemic involvement. We present a managed case of a 64-year-old male with solitary bone plasmacytoma of the right proximal femur, who presented as a pathological subtrochanteric femur fracture. Case Report A 64-year-old male presented to our outpatient department with pain in the right hip and restricted range of motion following a trivial trauma. The radiographs showed an osteolytic lesion in the right proximal femur with a right subtrochanteric femur fracture. A magnetic resonance imaging scan revealed a well-defined lesion in the right proximal femur. A 18F-fluorodeoxyglucose positron emission tomography did not show a lesion at any other site suggesting that the lesion was solitary. A serum protein electrophoresis study was normal and the urine was negative for myeloma protein. The patient had a score of 12 as per Mirel’s criteria and hence required operative intervention and fixation. The patient was managed with a thorough mechanical and chemical curettage of the lesion followed by fixation with a proximal femur locking plate and augmentation with fibula and iliac crest bone graft. He was then given a chemotherapy regimen consisting of nine cycles of bortezomib, lenalidomide, and dexamethasone. Conclusion Solitary bone plasmacytoma is a rare neoplasm of the bone. Early diagnosis and intervention are required to manage it and prevent its progression to multiple myeloma, which is a more aggressive entity and lies at the other end of the spectrum of plasma cell dyscrasias. Management of this lesion requires an active participation of the hematologist and a holistic approach which includes radiotherapy or surgery with possible adjuvant chemotherapy.
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Affiliation(s)
- Rudra M Prabhu
- Department Of Orthopaedics, Seth G.S. Medical College and K.E.M Hospital, Mumbai, Maharashtra, India
| | - Swapnil A Keny
- Department Of Orthopaedics, Seth G.S. Medical College and K.E.M Hospital, Mumbai, Maharashtra, India
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15
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Zhao R, Chen Z, Zhao S, Cheng Y, Zhu X. Prognosis of solitary bone plasmacytoma of the extremities: A SEER-based study. Medicine (Baltimore) 2021; 100:e26568. [PMID: 34190199 PMCID: PMC8257843 DOI: 10.1097/md.0000000000026568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/10/2021] [Indexed: 01/04/2023] Open
Abstract
Due to the rarity of solitary bone plasmacytoma (SBP), few studies reported the prognosis and survival predictors of SBP, especially for patients with extremity SBP.A total of 552 patients with extremity SBP were identified from the Surveillance Epidemiology and Ends Results (SEER) database between 1973 and 2016. In order to obtain independent predictors of survival, we performed both univariate and multivariate analysis via Cox proportional hazards model. Additionally, we used the Kaplan-Meier method to construct survival curves.The mean and median age at diagnosis of all patients were 64 and 65 years, respectively. The ratio of male versus women was 1.3:1. Overall survival for this special population was 51.2% and 34.9% at 5 and 10 years, respectively. Cancer-specific survival (CSS) for this special population was 63.5% and 47.5% at 5 and 10 years, respectively. Age at diagnosis and radiotherapy treatment were found to be significant independent predictors of both overall survival and CSS. Additionally, multivariate analysis showed that year of diagnosis and marital status were significantly correlated with CSS.This is the first study to identify prognostic factors of extremity SBP by using the SEER database. Our findings highlight that radiotherapy is the mainstream treatment for extremity SBP. Additionally, age, year of diagnosis, and marital status were significant independent predictors of survival. Knowledge of these survival predictors may help clinicians provide appropriate management for extremity SBP patients.
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Affiliation(s)
- Renbo Zhao
- Department of Orthopedics, Taizhou Tumor Hospital, Wenling, Zhejiang, China
| | - Zhaoxin Chen
- Department of Orthopedics, Qingtian People's Hospital, Lishui, Zhejiang, China
| | - Sujun Zhao
- Department of Endocrinology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Yali Cheng
- Department of Obstetrics and Gynecology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Xiaobo Zhu
- Department of Orthopedics, Taizhou Tumor Hospital, Wenling, Zhejiang, China
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16
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Merzouqi B, Halily S, Oukessou Y, Regragui M, Abada R, Mahtar M. Unusual presentation of a soft palate mass: A rare case report of solitary extramedullary plasmacytoma. Int J Surg Case Rep 2021; 79:193-197. [PMID: 33482447 PMCID: PMC7819814 DOI: 10.1016/j.ijscr.2021.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 11/06/2022] Open
Abstract
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.
Introduction 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). Case presentation 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. Discussion 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. Conclusion 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).
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Affiliation(s)
- B Merzouqi
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Casablanca University Hospital, Casablanca, Morocco.
| | - S Halily
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Casablanca University Hospital, Casablanca, Morocco
| | - Y Oukessou
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Casablanca University Hospital, Casablanca, Morocco
| | - M Regragui
- Pathology Department, Casablanca University Hospital, Casablanca, Morocco
| | - R Abada
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Casablanca University Hospital, Casablanca, Morocco
| | - M Mahtar
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Casablanca University Hospital, Casablanca, Morocco
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17
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Alghisi A, Borghetti P, Maddalo M, Roccaro AM, Tucci A, Mazzola R, Magrini SM, Lo Casto A, Bonù ML, Tomasini D, Pasinetti N, Peretto G, Bertagna F, Tomasi C, Buglione M, Triggiani L. Radiotherapy for the treatment of solitary plasmacytoma: 7-year outcomes by a mono-institutional experience. J Cancer Res Clin Oncol 2020; 147:1773-1779. [PMID: 33201300 DOI: 10.1007/s00432-020-03452-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/04/2020] [Indexed: 12/17/2022]
Abstract
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.
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Affiliation(s)
- Alessandro Alghisi
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy.
| | - Paolo Borghetti
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Marta Maddalo
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Aldo Maria Roccaro
- Clinical Research Development and Phase I Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | | | - Rosario Mazzola
- Radiation Oncology Department, IRCCS, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy
| | - Stefano Maria Magrini
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Antonio Lo Casto
- Radiation Oncology School, University of Palermo, Palermo, Italy
| | - Marco Lorenzo Bonù
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Nadia Pasinetti
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Gloria Peretto
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | | | - Cesare Tomasi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Brescia, Italy
| | - Michela Buglione
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
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18
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Brandt HH, Brockmeier SJ, Tetter N. Solitary extramedullary plasmacytoma of the larynx: a rare cause of dysphonia. BMJ Case Rep 2020; 13:13/9/e234478. [PMID: 32963040 DOI: 10.1136/bcr-2020-234478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Solitary extramedullary plasmacytoma (SEP) of the larynx is a rare haematological malignancy and an infrequent cause of persisting dysphonia. We present the case of a 54-year-old woman with a long-standing history of dysphonia. While clinical examination showed a rather inconspicuous prominent right vestibular fold, an MRI revealed a laryngeal mass with erosion of the thyroid cartilage. A biopsy taken during rigid endoscopy demonstrated plasma cell infiltration with light chain restriction amidst amyloid deposits. After exclusion of systemic involvement, the diagnosis of an SEP of the larynx with secondary amyloidosis was made. The patient received primary radiation therapy. Another biopsy taken 3 months after the end of therapy did not show any signs of ongoing neoplastic plasma cell disease. The patient was therefore considered to be in remission. She is currently receiving regular follow-up and has not shown signs of persistent or progressive disease for the past 18 months.
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Affiliation(s)
| | | | - Nora Tetter
- Department of Otolaryngology, Kantonsspital Aarau AG, Aarau, Switzerland
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19
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Kulkarni R, Ashshi R, Mupparapu M, Tanaka TI, Sollecito TP, Stoopler ET. Persistent orofacial pain associated with nasopharyngeal extramedullary plasmacytoma. SPECIAL CARE IN DENTISTRY 2020; 40:519-524. [DOI: 10.1111/scd.12501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Roopali Kulkarni
- Department of Oral Medicine University of Pennsylvania, School of Dental Medicine Philadelphia Pennsylvania
| | - Rawan Ashshi
- Department of Oral Medicine University of Pennsylvania, School of Dental Medicine Philadelphia Pennsylvania
| | - Mel Mupparapu
- Department of Oral Medicine University of Pennsylvania, School of Dental Medicine Philadelphia Pennsylvania
| | - Takako I. Tanaka
- Department of Oral Medicine University of Pennsylvania, School of Dental Medicine Philadelphia Pennsylvania
| | - Thomas P. Sollecito
- Department of Oral Medicine University of Pennsylvania, School of Dental Medicine Philadelphia Pennsylvania
| | - Eric T. Stoopler
- Department of Oral Medicine University of Pennsylvania, School of Dental Medicine Philadelphia Pennsylvania
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20
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Bujoreanu I, Hogan C, Virk JS. Multiple Upper Aerodigestive Tract Masses Presenting With Stridor-A Rare Case of Aggressive Multifocal Extramedullary Plasmacytoma. EAR, NOSE & THROAT JOURNAL 2020; 101:186-188. [PMID: 32791898 DOI: 10.1177/0145561320949704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Extramedullary plasmacytomas represent a rare group of B-cell malignancies that arise outside the bone marrow and their disease process is still poorly understood. Here, we will describe a case of a 76-year-old patient who presented with a large chest wall and subglottic mass causing airway compromise and stridor. Biopsies showed atypical plasma cells with prominent nucleoli which were in keeping with an extramedullary plasmacytoma. Disease progressed despite surgical debulking, targeted radiotherapy, and multiple chemotherapy regimens. Although response to treatment is classically good, patients occasionally present with aggressive disease.
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Affiliation(s)
- Iulia Bujoreanu
- Department of Surgery and Cancer, 4615Imperial College London, London, United Kingdom
| | - Chris Hogan
- Department of Otolaryngology, 129367Charing Cross Hospital, London, United Kingdom
| | - Jagdeep S Virk
- Department of Otolaryngology, 129367Charing Cross Hospital, London, United Kingdom
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21
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Nakaya A, Tanaka H, Yagi H, Ohta K, Shibayama H, Kohara T, Kanda J, Shindo M, Shimura Y, Kosugi S, Kida T, Kaneko H, Imada K, Karasuno T, Matsuda M, Iida M, Adachi Y, Fuchida SI, Uoshima N, Uchiyama H, Takahashi R, Matsui T, Wada K, Kiyota M, Shimazaki C, Hino M, Kuroda J, Kanakura Y, Takaori-Kondo A, Nomura S, Matsumura I. Retrospective analysis of plasmacytoma in Kansai Myeloma Forum Registry. Int J Hematol 2020; 112:666-673. [PMID: 32783165 DOI: 10.1007/s12185-020-02961-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Aya Nakaya
- Division of Hematology, First Department of Internal Medicine, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi-city, Osaka, 570-8507, Japan. .,Kansai Myeloma Forum, Osaka, Japan.
| | - Hirokazu Tanaka
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Hideo Yagi
- Department of Hematology and Oncology, Nara Prefecture General Medical Center, Nara, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Kensuke Ohta
- Hematology Ohta Clinic, Shinsaibashi, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Hirohiko Shibayama
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Takae Kohara
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Junya Kanda
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Maki Shindo
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Yuji Shimura
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Satoru Kosugi
- Department of Internal Medicine (Hematology), Toyonaka Municipal Hospital, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Toru Kida
- Department of Internal Medicine (Hematology), Toyonaka Municipal Hospital, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Hitomi Kaneko
- Department of Hematology, Japanese Red Cross Osaka Hospital, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Kazunori Imada
- Department of Hematology, Japanese Red Cross Osaka Hospital, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Takahiro Karasuno
- Department of Hematology, Rinku General Medical Center, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Mitsuhiro Matsuda
- Department of Hematology, PL General Hospital, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Masato Iida
- Kawasaki Hospital, Internal Medicine, Hyogo, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Yoko Adachi
- Department of Internal Medicine, JCHO Kobe Central Hospital, Hyogo, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Shin-Ichi Fuchida
- Department of Hematology, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center, Kyoto, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Hitoji Uchiyama
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Ryoichi Takahashi
- Department of Hematology, Omihachiman Community Medical Center, Shiga, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Toshimitsu Matsui
- Department of Hematology, Nishiwaki Municipal Hospital, Hyogo, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Katsuya Wada
- Department of Hematology, Matsushita Memorial Hospital, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Miki Kiyota
- Department of Hematology, Matsushita Memorial Hospital, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Chihiro Shimazaki
- Department of Hematology, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center, Kyoto, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | | | - Junya Kuroda
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Yuzuru Kanakura
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Akifumi Takaori-Kondo
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Shosaku Nomura
- Division of Hematology, First Department of Internal Medicine, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi-city, Osaka, 570-8507, Japan.,Kansai Myeloma Forum, Osaka, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka, Japan.,Kansai Myeloma Forum, Osaka, Japan
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22
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Di Giuliano F, Picchi E, Muto M, Calcagni A, Ferrazzoli V, Da Ros V, Minosse S, Chiaravalloti A, Garaci F, Floris R, Muto M. Radiological imaging in multiple myeloma: review of the state-of-the-art. Neuroradiology 2020; 62:905-923. [DOI: 10.1007/s00234-020-02417-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 03/26/2020] [Indexed: 12/16/2022]
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23
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Yuce Sari S, Yazici G. In Regard to Mignot et al. Int J Radiat Oncol Biol Phys 2020; 106:1109-1110. [DOI: 10.1016/j.ijrobp.2019.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 12/26/2019] [Indexed: 10/24/2022]
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24
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Consensus Guidelines on the Diagnosis of Multiple Myeloma and Related Disorders: Recommendations of the Myeloma Canada Research Network Consensus Guideline Consortium. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 20:e352-e367. [PMID: 32249195 DOI: 10.1016/j.clml.2020.01.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/17/2020] [Accepted: 01/24/2020] [Indexed: 02/07/2023]
Abstract
Multiple myeloma (MM) is a plasma cell (PC) malignancy of terminally differentiated B lymphocytes that is typically associated with the secretion of partial and/or complete monoclonal immunoglobulins and a constellation of particular symptoms and signs. MM is a treatable condition, and timely diagnosis is essential to limit or avoid irreversible target-organ damage and to prolong survival. The Myeloma Canada Research Network Consensus Guideline Consortium (MCRN-CGC) proposes national consensus recommendations for the diagnosis of MM and associated PC neoplasms. The focus is on widely available tests but also highlights recent advancements that are important to include in the diagnostic paradigm. By clarifying and updating the required laboratory, radiographic, and bone marrow investigations, the MCRN-CGC hopes to address the needs of Canadian physicians and people living with MM across the country through accurate and timely diagnosis of MM, as well as appropriate initial stratification to improve treatment selection and outcomes. The MCRN-CGC will periodically review the recommendations herein and update as necessary. Recommendations on the therapeutic approaches and associated monitoring of MM will follow.
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25
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Plasmocytome solitaire osseux : expérience du service de radiothérapie de l’hôpital militaire d’instruction Mohammed-V de Rabat (Maroc). Cancer Radiother 2019; 23:867-873. [DOI: 10.1016/j.canrad.2019.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/15/2019] [Accepted: 06/18/2019] [Indexed: 11/22/2022]
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26
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Abstract
Bone pathology can be challenging because the skeleton is a living tissue prone to developing a diverse array of inflammatory, metabolic, genetic, reactive, circulatory, and neoplastic abnormalities. Several areas of bone pathology are particularly difficult or problematic for hematopathologists given the close resemblance of some hematologic entities to primary/metastatic bone lesions; examples include plasmacytic disorders versus osteoblastic tumors and lymphoma/leukemia versus round cell tumors of bone. This article provides a conceptual and practical overview of selective bone disorders commonly encountered in the differential diagnosis of hematologic diseases.
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Affiliation(s)
- Deniz Peker
- Department of Pathology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249, USA
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249, USA
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249, USA.
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27
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Basavaiah SH, Lobo FD, Philipose CS, Suresh PK, Sreeram S, Kini H, Sahu KK, Prasad K. Clinicopathological spectrum of solitary Plasmacytoma: a single center experience from coastal India. BMC Cancer 2019; 19:801. [PMID: 31412808 PMCID: PMC6693151 DOI: 10.1186/s12885-019-5976-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 07/24/2019] [Indexed: 11/10/2022] Open
Abstract
Background Plasma cell disorders are a rare group of hematological malignancies that accounts for 10% of all hematological neoplasms. Solitary plasmacytomas are rarer entities accounting for less than 5% of all the plasma cell dyscrasias. They encompass three subtypes - Solitary Plasmacytoma of Bone (SPB) and Solitary Extramedullary Plasmacytoma (SEP) and multiple solitary plasmacytomas (MSP). In this study, we discuss the clinical, histopathological and immunohistochemical characteristics of solitary plasmacytomas. Methods A 13 year retrospective analysis of solitary plasmacytomas was performed from a single tertiary care center. Bone marrow evaluation was done concurrently at the time of diagnosis to rule out the presence of multiple myeloma. Results A total of 29 cases fulfilled the diagnostic criteria for SP during the study period. SPB accounted for 55.2%, SEP for 44.4% and MSP for 3.4% of the cases. The most common sites involved were the paranasal sinuses and vertebrae. Other infrequent sites included lymph node, tonsil and lungs. The mean age of presentation of SPB was a decade later than SEP. A male preponderance was observed in both subtypes. Conclusion Solitary plasmacytoma is a rare entity, the diagnosis of which requires a systematic approach. There is limited data available in the literature on the clinico-pathological characteristics of SP from India.
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Affiliation(s)
- Sridevi Hanaganahalli Basavaiah
- Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Flora D Lobo
- Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Cheryl Sarah Philipose
- Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India.
| | - Pooja K Suresh
- Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Saraswathy Sreeram
- Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Hema Kini
- Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Kausalya K Sahu
- Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Krishna Prasad
- Medical Oncologist, Mangalore Institute of Oncology, Mangalore, Karnataka, India
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Solitary bone plasmacytoma compression injury disguised as back pain: a case report. Spinal Cord Ser Cases 2019; 5:16. [PMID: 30774986 DOI: 10.1038/s41394-019-0161-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/21/2019] [Accepted: 01/27/2019] [Indexed: 02/01/2023] Open
Abstract
Introduction Low back pain is a leading disability worldwide; however, it is not often the result of a serious underlying condition such as a tumor. As a result, diagnosis of a serious underlying cause of low back pain may be delayed, such as in this case. Case presentation We describe a case of a man presenting with low back pain, who was eventually diagnosed with solitary bone plasmacytoma (SBP) causing spinal cord compression from approximately T7-T9. The patient was classified as T8 ASIA C-Incomplete Paraplegia. He underwent an emergency T7-T9 open posterior laminectomy and resection of the epidural mass/tumor. Following an intensive course of rehabilitation treatment, the patient progressed to ASIA D. Discussion Although SBP of the spine is rare, back or neck pain is a common initial presentation. This case is unique in that we provide a detailed description of both medical and rehabilitation diagnosis and treatment. We also suggest that persistent back pain warrants complete MRI spinal imaging to provide proper diagnosis and prompt treatment for cases with a serious underlying condition.
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Miwa W, Hiratsuka T, Tei S, Sato K, Yo K. Solitary extramedullary plasmacytoma of the rectum complicating ulcerative colitis. Clin J Gastroenterol 2018; 12:160-165. [PMID: 30238285 DOI: 10.1007/s12328-018-0907-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 09/13/2018] [Indexed: 01/09/2023]
Abstract
Solitary extramedullary plasmacytoma (EMP) arising in the rectum is an extremely rare clinical entity. Only ten cases have been reported in the English-language literature. We experienced a case of an EMP in the rectum of a 55-year-old man with an 8-year history of proctitis-type ulcerative colitis (UC). The plasmacytoma appeared as an 8-mm semipedunculated polypoid lesion in the actively inflamed rectal mucosa when the remittent UC flared. The tumor was treated using endoscopic mucosal resection. This is the second case of rectal EMP associated with UC after a similar report was published in 2004. Both patients had a chronic history of proctitis-type UC and were taking no immunosuppressive agents that could cause Epstein-Barr virus-associated plasmacytoma, such as thiopurines. The UC activity seemed to correspond well with the development of the rectal EMP. Therefore, we herein discuss a possible association between rectal EMP and UC and review the past literature of rectal EMP.
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Affiliation(s)
- Wataru Miwa
- Division of Internal Medicine, Hiratsuka Gastroenterological Hospital, 3-2-16 Nishiikebukuro, Toshima-ku, Tokyo, 171-0021, Japan.
| | - Takashi Hiratsuka
- Division of Internal Medicine, Hiratsuka Gastroenterological Hospital, 3-2-16 Nishiikebukuro, Toshima-ku, Tokyo, 171-0021, Japan
| | - Shutetsu Tei
- Division of Internal Medicine, Hiratsuka Gastroenterological Hospital, 3-2-16 Nishiikebukuro, Toshima-ku, Tokyo, 171-0021, Japan
| | - Ken Sato
- Division of Surgery, Hiratsuka Gastroenterological Hospital, Tokyo, Japan
| | - Kato Yo
- Department of Pathology, Nikko Medical Center, Dokkyo Medical University, Tochigi, Japan
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Abstract
Multiple myeloma (MM) is a clonal malignancy of plasma cells that is newly diagnosed in ~30,000 patients in the US each year. While recently developed therapies have improved the prognosis for MM patients, relapse rates remain unacceptably high. To overcome this challenge, researchers have begun to investigate the therapeutic potential of oncolytic viruses as a novel treatment option for MM. Preclinical work with these viruses has demonstrated that their infection can be highly specific for MM cells and results in impressive therapeutic efficacy in a variety of preclinical models. This has led to the recent initiation of several human trials. This review summarizes the current state of oncolytic therapy as a therapeutic option for MM and highlights a variety of areas that need to be addressed as the field moves forward.
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Affiliation(s)
- Eric Bartee
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
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31
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Wu M, Cai L, Yan F, Xu K, Sun W, Deng Z, Xie Y. [Applications of one-stage total spondylectomy by anterior and posterior approaches for solitary plasmacytoma of cervical spine]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2018; 32:195-202. [PMID: 29806412 DOI: 10.7507/1002-1892.201709107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To investigate the feasibility of one-stage total spondylectomy by anterior and posterior approaches for treating solitary plasmacytoma (SP) of cervical spine. Methods Between June 2000 and March 2015, the clinical data, diagnosis, and treatment of 12 patients with SP of cervical spine were retrospectively analyzed. There were 8 males and 4 females, with a mean age of 46 years (range, 28-74 years). The mean disease duration was 8.4 months (range, 3-15 months). There were 2 cases in C 2 segment, 4 cases in C 3, 2 cases in C 4, 1 recurrent case in C 5, C 6, and 3 cases in C 7. According to WBB (Weinstein-Boriani-Biagini) surgical staging system, the tumor mainly occupied the vertebral body areas and expanded outside to 4 or 9 radiating zone in 8 cases, expanded both outsides to 4 or 9 radiating zones in 4 cases; 7 cases of them affected A to D layers, other 5 cases affected B to D layers. Preoperative Frankel system showed grade B in 1 case, grade C in 6 cases, and grade D in 5 cases. One vertebra segment was involved in 11 cases, and 2 vertebra segments were involved in 1 case. The unilateral vertebral artery was involved in 4 cases and bilateral vertebral artery in 1 case. One-stage total spondylectomy by anterior and posterior approaches for SP of cervical spine was applied in all patients, which all received adjuvant radiotherapy postoperatively. The operation time, intraoperative blood loss, complications, Frankel system, and visual analogue scale (VAS) score were recorded and analyzed. Results The operation time was 6.8-9.3 hours (mean, 7.2 hours), and the intraoperative blood loss was 1 100-2 600 mL (mean, 1 600 mL). Esophageal leakage occurred in 1 patient with C 5, C 6 recurrent SP at 1 week after operation and 1 case presented with fat liquefaction of wound, who were cured by symptomatic treatment. Other patients showed no neurological deficit, major vascular injury (especially vertebral artery), phrenic nerve injury, superior laryngeal nerve injury, laryngeal nerve injury, respiratory failure, or other complications. All the 12 patients were followed up 27-98 months (mean, 58 months). The symptoms of spinal cord compression disappeared or improved after operation. At last follow-up, the nerve function was recovered to Frankel grade E in all patients; the VAS score decrease to 1.1±0.7, showing significant difference when compared with preoperative value (6.7±2.7) ( t=2.485, P=0.014). Two patients had local recurrence at 29 months and 37 months after operation respectively, which were treated with adjuvant chemotherapy. One of them finally progressed to multiple myeloma and died of multiple organ failure after 43 months, the other one survived with residual tumor. One case presented with internal fixator loosening and breaking at 4 years after operation, who was performed revision surgery. The other patients had no tumor recurrence or malignant change during the follow-up, no complication such as internal fixator loosening or breaking occurred. Conclusion For patients with SP of cervical spine, surgical intervention is an acceptable treatment option. One-stage total spondylectomy by anterior and posterior approaches can decline the local recurrence and relieve the symptoms of spinal cord compression, so as to improve patients' life quality. However, patients with progression to multiple myeloma should be treated with individualized therapeutic regimen, and the prognosis may be poor.
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Affiliation(s)
- Minhao Wu
- Musculoskeletal Tumor and Spinal Central of Orthopedic Department, Zhongnan Hospital of Wuhan University, Wuhan Hubei, 430071, P.R.China
| | - Lin Cai
- Musculoskeletal Tumor and Spinal Central of Orthopedic Department, Zhongnan Hospital of Wuhan University, Wuhan Hubei, 430071,
| | - Feifei Yan
- Musculoskeletal Tumor and Spinal Central of Orthopedic Department, Zhongnan Hospital of Wuhan University, Wuhan Hubei, 430071, P.R.China
| | - Keke Xu
- Musculoskeletal Tumor and Spinal Central of Orthopedic Department, Zhongnan Hospital of Wuhan University, Wuhan Hubei, 430071, P.R.China
| | - Wenchao Sun
- Musculoskeletal Tumor and Spinal Central of Orthopedic Department, Zhongnan Hospital of Wuhan University, Wuhan Hubei, 430071, P.R.China
| | - Zhouming Deng
- Musculoskeletal Tumor and Spinal Central of Orthopedic Department, Zhongnan Hospital of Wuhan University, Wuhan Hubei, 430071, P.R.China
| | - Yuanlong Xie
- Musculoskeletal Tumor and Spinal Central of Orthopedic Department, Zhongnan Hospital of Wuhan University, Wuhan Hubei, 430071, P.R.China
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Breda MS, Menezes AS, Miranda DA, Rocha J. Temporal bone neoplasia: a rare entity. BMJ Case Rep 2018; 2018:bcr-2017-223590. [PMID: 29437713 DOI: 10.1136/bcr-2017-223590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Miguel Sá Breda
- Department of Otorhinolaryngology-Head & Neck Surgery, Hospital de Braga, Braga, Portugal
| | - Ana Sousa Menezes
- Department of Otorhinolaryngology-Head & Neck Surgery, Hospital de Braga, Braga, Portugal
| | - Daniel Alves Miranda
- Department of Otorhinolaryngology-Head & Neck Surgery, Hospital de Braga, Braga, Portugal
| | - Jaime Rocha
- Neuroradiology Department, Hospital de Braga, Braga, Portugal
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