Extramedullary plasmacytoma of the trachea

Zhang, Xi; Su, Lei; Ran, Yu-Ge; Qie, Shuo; Zhang, Xin; Лю, Чан; Shi, Hongyun

doi:10.1097/md.0000000000009594

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…In a case report described by Karakullukcu et al., surgical debulking combined with photodynamic therapy was employed to manage residual EMP tumor resulting in a successful outcome ( 31 ). Another therapeutic approach presented in the available literature involved bronchoscopic electrocautery snare combined with CO2 cryotherapy, followed by RTH for EMP located in the trachea ( 32 ). In the presented case report, a surgical debulking approach was employed because radical resection was not feasible.…”

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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“…D’Aguillo et al [18] suggested that aggressive radiotherapy was the most common treatment modality for EMP, and a combination of surgery and radiotherapy led to better survival outcomes. Zhang et al [19] reported a case of a patient with tracheal EMP treated with surgery, followed by adjuvant radiotherapy, which achieved better local control too. We consider that the EMP should follow the principle of individualized treatment, taking into account the location and the size of the lesions.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal extramedullary plasmacytoma

Wang

Li²,

Zhang³

et al. 2018

Medicine

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Rationale:The incidence of extramedullary plasmacytoma (EMP) accounts for 3% to 4% of all cases of generalized plasmacytoma. The most common pathogenic sites are the head and the neck. It is noteworthy that the pathogenic site in this case is extraperitoneal, which is uncommon in clinical practice. In this case report, we aim to discuss the clinical features and diagnosis as well as the treatment methods of EMP.Patient concerns:A 30-year-old female was admitted to our hospital due to a palpable right upper abdominal mass without symptoms of abdominal pain, diarrhea, constipation, fever, or oliguria.Diagnosis and interventions:Enhanced CT scan showed a right retroperitoneal mass, which we considered to be isolated fibroma. Multiple myeloma (MM) was excluded through whole-body diffusion weighted imaging (DWI) and bone marrow biopsy. The patient underwent retroperitoneal tumor resection, and the postoperative pathology revealed plasmacytoma. Thereafter, she received only postoperative radiotherapy.Outcomes:During the radiotherapy, the patient's condition and appetite were acceptable with I° gastrointestinal reaction. The CT examination of the chest and upper abdomen performed 4, 8, and 12 months after the radiotherapy still showed postoperative and postradiotherapy changes after retroperitoneal plasmacytoma resection without obvious abnormal signs. No recurrence and metastasis were detected after a one-year follow-up.Lessons:Retroperitoneal extramedullary plasmacytoma (EMP) is a rare condition that is frequently a diagnostic challenge, mainly due to its unusual location and nonspecific symptoms, especially in the early stages. The diagnosis of EMP is made through a combination of imaging and pathological examination. Presently, the combinations of radiotherapy and surgery or radiotherapy are the primary treatments, usually leading to an acceptable local control rate. The application of chemotherapy, however, should be carefully considered.

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Outcome Analysis of Solitary Extramedullary Plasmacytoma in the Head and Neck: A Clinical Perspective

Chuang,

Lee

et al. 2024

Head & Neck

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IntroductionSolitary extramedullary plasmacytomas (SEP) of the head and neck are rare and pose unique challenges. This study aimed to explore the clinical spectrum and treatment outcomes of these neoplasms using multimodal management.MethodsA retrospective review of 13 patients with SEP of the head and neck. Data on demographics, clinical presentation, diagnostics, treatment, and survival outcomes were analyzed.ResultsOne patient refused the treatment and was lost to follow‐up. Another one received operation alone. The other 11 patients underwent surgical resection when feasible and showed favorable responses to radiation. Two of them (16.7%) experienced local recurrence, and another two patients (16.7%) progressed to multiple myeloma (MM) within the first 2 years following the initial treatment. Tumor > 2.6 cm significantly affected the post‐radiation prognosis.ConclusionAlthough radiotherapy yields favorable immediate outcomes in our limited case series, a subset of cases progresses to MM within the initial 2 years. Despite all tumors being categorized as Stage I, tumor size may still influence prognosis.

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Extramedullary plasmacytoma of the trachea

Cited by 9 publications

References 17 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

Retroperitoneal extramedullary plasmacytoma

Outcome Analysis of Solitary Extramedullary Plasmacytoma in the Head and Neck: A Clinical Perspective

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