Osteosclerotic Plasmacytoma of maxillary bone (orbital floor)

Abstract

Plasma cell neoplasms have been classified as multiple myeloma, solitary plasmacytoma and extramedullary plasmacytoma. They are usually considered as osteolytic lesions of bone except for the rare occurrence of osteosclerotic lesions. This paper describes the first reported osteosclerotic plasmacytoma of the maxillary bone and orbital floor. The difficulties in establishing a diagnosis and the relationship to other plasma cell neoplasms are discussed.Osteosclerotic plasmacytomas are a rare variant of plasma cell tumors which usually produce osteolytic lesions rather than bony sclerosis. Sixty-eight patients with the osteosclerotic variant have appeared in the world literature, with an overall incidence of about 1 per cent in a large series of plasma cell neoplasms (Dreidger and Pruzanski, 1979). There have been only six previous cases of solitary osteosclerotic plasmacytomas reported (Morley and Schweiger, 1964; Roberts et al., 1974; Rodriguez et al. 1976; Rushton, 1965; Schneinker, 1938; Brigham Medical Review, 1961) involving spine, sternum, or rib. None have previously been reported in the head and neck area.Plasma cell tumors have been classified into multiple myeloma, solitary plasmacytomas of bone, and extramedullary plasmacytomas. Multiple myeloma is a disseminated plasma cell malignancy characterized by the production of homogeneous immunoglobulins (whole or fragments) which appear in the serum and urine. Plasma cell tumors can also occur as solitary plasmacytomas, usually in bone, but also in soft tissue. With time, most solitary plasmacytomas develop disseminated disease with all the characteristics of multiple myeloma (Wiltshaw, 1976). Extramedullary plasmacytomas arise in soft tissue rather than bone, and primarily occur in the head and neck region. Clinically, they remain localized and less frequently develop into disseminated myeloma.

Solitary plasmacytoma of the jaws: therapeutical considerations and prognosis based on a case reports systematic survey

“…In the case reports reviewed, the most common site of SBP appearance was the mandible, more precisely in posterior regions. 2 , 4 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 These findings confirm those found by Loh 26 and Pisano et al 31…”

“…The highest incidence of SBP occurred between the 4th and 6th decades of life. 2 , 4 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 The distribution by gender was balanced, accounting for 11 cases in women and 10 in men. These data corroborate the results obtained by Dores et al 12 …”

“…The patient's race was reported in only 7 case reports: 3 black patients, 3 Asian patients and 1 white patient. 2 , 4 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 Although most of the case reports did not report the race of the patients, a predilection of the SBP for white individuals is observed in the literature. 12 …”

Plasmocytome osseux solitaire de la mandibule : un cas clinique et revue de la littérature

“…Les lésions radioopaques sont exceptionnelles [9]. La tomodensitométrie permet d'affiner l'image radiologique et d'étudier l'extension vers les corticales et les parties molles adjacentes.…”

Solitary Plasmacytoma of the Zygoma in a 70-Year-Old Nigerian: A Case Report and Review of Literature

“…Chang et al [10] postulated that the lesion is twice as common in the spine as other bones in the body. While SBP is known to constitute less than 10% of plasma cell dyscrasias, it is however a known precursor of multiple myeloma [MM] as more than 50% of SBP patients have been reported to undergo systemic dissemination into MM [11]- [13]. Presence of abnormal serum immunoglobulin free light chain or relapse of treated solitary lesion are indicators of tumor progression to MM [12].…”