Anaplastic extramedullary plasmacytoma resistant to novel therapies: a case report

Jacevičiūtė, Emilija; Rudžianskienė, Milda; Dambrauskienė, Rūta; Vajauskas, Donatas; Gerbutavičius, Rolandas

doi:10.1515/oncologie-2023-0054

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…Histopathological examination of the tumor tissue reveals a dense infiltrate of plasmablastic or anaplastic plasma cells, which may be immature or mature ( 18 ). However, the similarities in histopathological features and the high pleomorphism of plasma cells may lead to confusion with aggressive lymphoma, rhabdomyosarcoma, or other sarcomas ( 19 ). Specifically, EMP should be distinguished from plasmablastic lymphoma, which exhibits overlapping features with myeloma and lymphoma.…”

Section: Discussionmentioning

confidence: 99%

Case report: An uncommon presentation of extramedullary plasmacytoma without a concurrent diagnosis of multiple myeloma

Stawarz,

Galazka,

Gorzelnik

et al. 2024

Front. Oncol.

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IntroductionExtramedullary plasmacytoma (EMP) is an uncommon solitary tumor originating from neoplastic plasma cells located outside the bone marrow. Despite its rarity, the occurrence of EMP without a concurrent diagnosis of multiple myeloma (MM) is considered extremely rare. Approximately 80–90% of EMP cases are found in the head and neck region, with a higher incidence in men aged between 50 and 60 years. The current treatment modalities include radiotherapy (RT) as a first-line approach, with surgery or chemotherapy regarded as other therapeutic options. While RT proves effective in the majority of EMP cases, there are instances where the tumor remains refractory to radiation. In this case report, we present an unusual scenario of EMP resistant to RT without concurrent signs of multiple myeloma which was successfully treated with surgery followed by systemic therapy.Case reportA 72-year-old male was admitted to the Head and Neck Cancer Clinic with a 6-month history of swallowing difficulties. He denied experiencing weight loss or pain on swallowing. Basic laboratory tests yielded results within normal limits, except for beta-2 microglobulin. Physical examination revealed an enlarged submandibular lymph node on the right side. Fiberoptic examination identified a soft tissue polypoid mass within the right piriform fossa, slightly protruding into the vocal slit. A CT scan displayed a well-circumscribed 2 cm polypoid, homogeneously enhancing soft tissue mass adjacent to the posterior surface of the epiglottis and the right side of the tongue base. Bone marrow biopsy revealed no abnormalities, and there were no clinical or laboratory signs of multiple myeloma. Based on the tumor biopsy results and imaging studies, a diagnosis of EMP was made. Due to the lack of response to RT, surgical removal of the tumor was pursued, followed by systemic therapy. Ultimately, the patient achieved full recovery with effective disease control.ConclusionIn conclusion, EMP without concurrent multiple myeloma is an exceedingly rare condition that demands a multidisciplinary approach for both diagnosis and treatment. Moreover, although RT continues to be the primary standard treatment for EMP, in some cases other therapeutic regimens prove to be successful.

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Section: Discussionmentioning

confidence: 99%

Case report: An uncommon presentation of extramedullary plasmacytoma without a concurrent diagnosis of multiple myeloma

Stawarz,

Galazka,

Gorzelnik

et al. 2024

Front. Oncol.

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Nasal cavity extramedullary plasmacytoma: literature review and clinical experience

Vivekanand,

Tara

2024

Romanian Journal of Rhinology

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BACKGROUND. Extramedullary plasmacytoma is an extremely rare solitary plasma cell neoplasm that occurs in locations other than bone, without involving the bone marrow. It is commonly located in the upper aerodigestive tract. In the head and neck region, the most frequent location is the sinonasal region. MATERIAL AND METHODS. A systemic review in accordance with the PRISMA guidelines was done with research works in PubMed, Elsevier database, Cochrane library, Web of Science, Scopus, Crossref and Google Scholar. The search was carried out using the keywords “plasmacytoma and nose”, “extramedullary plasmacytoma”, “extramedullary plasmacytoma of nose”, “plasmacytoma and nasal cavity”, and “extramedullary plasmacytoma of nasal cavity”. RESULTS. We analysed 27 research works with a total number of 32 cases. The most common presenting symptoms were nasal cavity bleeding. The disease showed a male preponderance (78.1%). Bone erosion was seen in 7 cases. The histopathological examination showed plasma cells arranged predominantly as a uniform population or sheet-like appearance. A common immunohistochemical marker was CD138 (11 cases). Treatment was primarily radiotherapy (43.7%). We are also reporting a case of a 53-year-old male with plasmacytoma of the middle turbinate managed by wide resection and postoperative radiotherapy. CONCLUSION. Though a less common condition, in a case of polypoidal-like lesion with bleeding tendency, the clinician should keep in mind the possibility of extramedullary plasmacytoma. The diagnosis is made with histopathological examination and immunohisto-chemistry of the tissue involved. Treatment can be radiotherapy, surgery, or a combination of modalities.

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Anaplastic extramedullary plasmacytoma resistant to novel therapies: a case report

Cited by 2 publications

References 22 publications

Case report: An uncommon presentation of extramedullary plasmacytoma without a concurrent diagnosis of multiple myeloma

Case report: An uncommon presentation of extramedullary plasmacytoma without a concurrent diagnosis of multiple myeloma

Nasal cavity extramedullary plasmacytoma: literature review and clinical experience

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