An extramedullary plasmacytoma in the testicle: A case report and review of the literature

Extraosseous Plasmacytomas: A Radiologist's Perspective-A Narrative Review of the Literature

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.

Bilateral Testicular Mass Presenting as a Rare Manifestation of Extramedullary Plasmacytoma on 18F-FDG PET/CT

ABSTRACT

We present the case of a 48-year-old man diagnosed with metastatic Ewing sarcoma who was referred for 18F-FDG PET/CT for treatment response evaluation following chemoradiotherapy. The patient also had complaints of new-onset testicular swelling at the time of imaging. Although the metastatic bone disease showed a complete metabolic response to treatment, 18F-FDG PET/CT demonstrated significantly increased metabolic activity in bilateral testicular mass. Consequently, the patient underwent bilateral orchiectomy, and histopathologic examination revealed bilateral testicular plasmacytoma, a rare manifestation of extramedullary plasmacytoma.

Refractory multiple myeloma with extramedullary plasmacytoma of the spleen and suspicious teratoma: a rare case report and literature review

Multiple myeloma (MM) is a type of malignant disease that is characterized by a clonal proliferation of plasma cells within the bone marrow. Relapsed and refractory multiple myeloma (RRMM) is a subtype of MM that is unreactive to salvage therapy and progresses during treatment or within 60 days of the last therapy in patients who achieved a minimal response before progression of disease. This usually results in a poor prognosis. Extramedullary plasmacytoma (EMP) occurs when MM occasionally develops in tissues other than bones marrow. To the best of our knowledge, case studies of the presence of EMPs in the spleen have rarely been reported. Teratoma is a type of congenital tumor that consists of tissue that arises from pluripotent embryonic cells. Here we report a case of refractory immunoglobulin G (IgG) MM with both splenic plasmacytomas and a suspicious teratoma. To investigate the clinical and treatment features of patients under similar conditions, we also reviewed the available literature supporting the useful information in the pathogenesis, diagnosis and treatment of RRMM with EMP.

Lesions Without Borders: Scrotal Lesions That Involve Both the Intratesticular and Extratesticular Regions

OBJECTIVE

Differentiation of scrotal lesions is often dictated by whether they are intraor extratesticular. However, these regions are not entirely isolated, and disease processes can span both spaces. We review a variety of lesions that can involve both regions, describe the relevant anatomy, and illustrate their imaging appearances.

CONCLUSION

Identification of involvement of both intra- and extratesticular regions by a single process can narrow the differential considerations and help arrive at the correct diagnosis.

Bilateral synchronous plasmacytoma of the testis

Extramedullary plasmacytoma (EMP) is usually seen in the head and neck regions and in the upper respiratory, gastrointestinal, and central nervous systems. Testis is a rare site for EMP, and bilateral synchronous testicular plasmacytoma occurring as an isolated event at initial presentation has been reported only once previously. We present herein the second such report in a 70-year-old man who underwent bilateral orchidectomy.