Biclonal Extramedullary Plasmacytoma Arising in the Peritoneal Cavity: Report of a Case

Yoshida, Takayoshi; Soda, Kuniyasu; Yamada, Shigeki; Nakahara, Moriyasu; Nishida, Junji; Kametaka, Minako; Konishi, Fumio

doi:10.1007/s00595-003-2705-1

Cited by 9 publications

(10 citation statements)

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“…SP has been reported to be highly radiosensitive and chemosensitive [5,6,8]. However, as seen in our case and in the other reports [4,9], the prognosis and the sensitivity of SP to radiochemotherapy may be poor, and the course of the disease may be very aggressive. Although thalidomide can produce an important response rate in patients with MM [9], its efficacy in preventing development of plasmacytoma in our case, as observed also by other authors [7,9], was very limited.…”

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confidence: 57%

“…Solitary plasmacytoma (SP) is defined as a neoplastic proliferation of plasma cells which originate in almost any tissue throughout the body, without any sign of systemic spread [4,5]. Primary SPs are considered clinically distinct entities and approximately 2-10% of MM patients who present with SPs develop the generalized disease later [6].…”

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confidence: 99%

“…Treatment options for SP include surgery, radiotherapy, chemotherapy, and combined therapy such as surgery with radiation or chemotherapy or both [4]. SP has been reported to be highly radiosensitive and chemosensitive [5,6,8].…”

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confidence: 99%

“…SPs are rare occurrences and categorized into two groups: SPs of the bone (SPB), which account for 2-5% of all plasma cell neoplasms; and extramedullary plasmacytomas (EMPs) of the soft tissue, which account for 3% of all such neoplasms [5]. The majority of EMPs develop in the soft tissue of the head and neck, and approximately 10% of EMPs occur in the gastrointestinal tract, the stomach being the most frequent site [4,5]. Extramedullary plasmacytomas which develop secondary to frank MM have an incidence of 15% to 20% in patients at diagnosis and an additional 15% during the course of the disease [7].…”

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Extramedullary Plasmacytoma Involving the Abdominal Vessels and Pancreas

et al. 2007

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We read with great interest the article by Attwell and colleagues [1] in a recent issue of Digestive Diseases and Sciences that described a case of IgA multiple myeloma (MM) involving two unusual extramedullary sites: the porta hepatis and peritoneum. The involvement of abdominal vessels and pancreas by plasma cell neoplasms is very rare and usually diagnosed at autopsy [1][2][3]. We would like to describe and share our experience in a patient with known MM who developed plasmacytoma on the chest wall and in the abdomen involving the abdominal vessels and pancreas, without concurrent relapse of the disease, and to add some points concerning the treatment of extramedullary plasmacytomas (EMP).A 64-year-old-man was diagnosed to have stage II MM of the IgA(λ) subtype in 2001. He was given a chemotherapy regimen with six courses of melphalan and prednisolone and achieved a plateau phase. In 2002, at the sixth month of the plateau phase, the patient developed a painless mass in the right posterior-inferior region of the thorax. Chest computed tomography (CT) demonstrated a heterogeneously enhanced mass without destruction of the ribs in the chest wall with dimensions of 14 × 9 × 6 cm. Abdominal CT was normal. Bone marrow examination showed no relapse of MM. The results of a radiographic survey did not show an additional lesion. The patient was scheduled for a chest wall mass resection and reconstructive surgery. The operative course was uneventful. The excised chest wall tumor measured 14 × 12 × 4.5 cm. Examination of the permanent section revealed that the chest wall tumor was an IgA(λ)-type plasmacytoma. Six courses of melphalan-prednisolone were given and thalidomide therapy was started. The patient continued on routine controls and remained in plateau phase during follow-up, and the chest wall tumor did not show recurrence.In 2004, 18 months after resection of the chest wall plasmacytoma, he was readmitted to hospital with complaints of masses and jaundice lasting for 3 weeks. One of the masses was located below the surgical resection site and the other was on the right upper quadrant, extending through the epigastric region. Laboratory data were as follows: aspartate aminotransferase (AST), 87 U/L (normal range, 0-40); alanine aminotransferase (ALT), 135 U/L (normal range, 0-43); alkaline phosphatase, 129 U/L (normal range, 37-147); total bilirubin, 3.1 mg/dl (normal range, 0-1.1); direct bilirubin, 2.5 mg/dl (upper limit, 0.4); lactate dehydrogenase, 306 U/L (normal range, 125-243); total protein, 6.8 g/dl; albumin, 3.8 g/dl; creatinine, 1.1 mg/dl; uric acid, 3.8 mg/dl; calcium, 9.2 mg/dl; IgA, 85.8 mg/dl (normal range, 70-400); IgG, 1280 (normal range, 700-1600); and IgM, 16.8 mg/dl (normal range, 40-230). Bone marrow aspiration and biopsy and serum protein electrophoresis demonstrated normal findings. Chest CT revealed a mass with destruction of the 10th and 11th ribs in the right chest wall with Springer

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Extramedullary Plasmacytoma Involving the Abdominal Vessels and Pancreas

et al. 2007

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“…These tumors could originate in a variety of anatomical sites, but most often, approximately 90% of cases, have been reported from the upper respiratory tract. Less than 10% of EMPs occur in the gastrointestinal tract, whereas the stomach is the most frequent site of its occurrence 2,3 . There are only several cases described in the literature of EMP in the duodenum and few cases involving the pancreas or both duodenum and pancreas [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] .…”

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confidence: 99%