Diagnosis, treatment, and response assessment in solitary plasmacytoma: updated recommendations from a European Expert Panel

Abstract

Solitary plasmacytoma is an infrequent form of plasma cell dyscrasia that presents as a single mass of monoclonal plasma cells, located either extramedullary or intraosseous. In some patients, a bone marrow aspiration can detect a low monoclonal plasma cell infiltration which indicates a high risk of early progression to an overt myeloma disease. Before treatment initiation, whole body positron emission tomography–computed tomography or magnetic resonance imaging should be performed to exclude the presence of additional malignant lesions. For decades, treatment has been based on high-dose radiation, but studies exploring the potential benefit of systemic therapies for high-risk patients are urgently needed. In this review, a panel of expert European hematologists updates the recommendations on the diagnosis and management of patients with solitary plasmacytoma.Electronic supplementary materialThe online version of this article (10.1186/s13045-017-0549-1) contains supplementary material, which is available to authorized users.

Extramedullary Plasmacytoma Involving the Heart: A Case Report and Focused Literature Review

“…The role of chemotherapy is controversial and usually has no benefit in inducing or maintaining relapse. It might slow down the rate of progression of plasmacytoma to multiple myeloma, but it has no benefit in reducing the rate of conversion [14][15][16]. In our case, due to the location of the tumor and the potential risk of cardiotoxicity, a decision was made against RT and the patient was managed with chemotherapy alone.…”

Imaging in myeloma with focus on advanced imaging techniques

“…50 Based on this evidence the IMWG, BSH and recent European expert Panel recommend WB DW-MRI first-line if available or FDG PET/CT in presumed solitary plasmacytoma. 6,27,51 One caveat of FDG PET/CT worth mentioning is in patients with solitary lytic lesions presenting with cord/ neural compromise in whom steroids have been administered, WB-MRI should be considered first-line as high dose steroids can reduce the sensitivity of FDG PET/CT.…”

Solitary extramedullary plasmacytoma of palatine tonsil – a rare albeit possible entity

“…A rare case of a solitary extramedullary plasmacytoma of the palatine tonsil with no sign of a systemic disease. 1 EMPs are found primarily in the head and neck region, especially in the sinonasal area; however, any other site can be affected as well. 2 EMPs are more common in men, with a peak incidence in the sixth decade of life.…”