Primary Plurifocal Extramedullary Plasmacytoma of Breast

Aagre, Suhas; Madabhavi, Irappa; Patel, Apurva; Anand, Asha; Panchal, Harsha; Parikh, Sonia

doi:10.1111/tbj.12601

Cited by 3 publications

(7 citation statements)

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“…Reducing tumor mass without a R0‐claim (no residual tumor remaining) may only be performed if it allows a rapid elimination of local symptoms (e.g., respiratory disability) and the effects of radiation therapy cannot be waited for. For most EMPs in the UAD region, surgery is not the best choice of treatment, as it may lead to serious mutilation 17,24–28 . In line with these considerations, the absolute numbers of surgeries as a sole treatment of EMP decreased in UAD regions, although this sole therapy approach remained among the three most commonly administered therapies in the UAD.…”

Section: Discussionmentioning

confidence: 99%

“…In EMP, there is normally no indication for chemotherapy, even if local lymph nodes are involved 17,24,38 . However, in case of large tumors, chemotherapy should be considered after radiotherapy, especially when the tumor is larger than 5 cm 26,39 . Furthermore, chemotherapy should be considered in case of a highly classified EMP according Bartl et al 40 and for refractory/persistent tumors, or recurrences 31 .…”

Section: Discussionmentioning

confidence: 99%

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Extramedullary plasmacytoma: Tumor occurrence and therapeutic concepts—A follow‐up

et al. 2022

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Background Extramedullary plasmacytoma (EMP) is a solitary tumor consisting of neoplastic plasma cells, with very little to no bone marrow involvement. EMPs are usually located in the head and neck region, but can also occur along the digestive tract, in lungs, or extremities. Methods Following our publication on EMP, which appeared in 1999 (Cancer 85:2305–14), we conducted a literature search for EMP‐related reports published between 1999 and 2021. The documented cases, as well as 14 of our own patients from the ENT Clinic Erlangen, were extensively analyzed. Results Between 1998 and 2021, 1134 patients with EMP were reported, for whom information about the tumor localization was available. Among those, 62.4% had EMP in the head and neck area and 37.6% in other body regions. Data on therapy were reported in 897 patients, including 34.3% who received radiation, 28.1% surgery, 22.6% a combination of surgery and radiation, and 15.9% another therapy. In 76.9% patients no recurrence or transformation to multiple myeloma (MM) was reported, 12.8% showed local recurrence and 10.2% developed MM. Radiotherapy alone was associated with a tendency for increased occurrence of MM. In patients with EMP of head and neck area, combination therapy (surgery and radiation) resulted in a 5‐year overall survival rate of 98.3%, surgery alone of 92.4%, and radiotherapy of 92.7%. Conclusions Collectively, our analyses indicate that surgical resection alone can achieve long‐term tumor control in patients with EMP, if the tumor can be removed within safe limits without causing serious functional impairment. However, if this is not certain, either radiation or a combination of surgery and radiation therapy is suggested as an effective means of local tumor control.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Extramedullary plasmacytoma: Tumor occurrence and therapeutic concepts—A follow‐up

et al. 2022

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“…Breast involvement is rare, with approximately 63 cases reported worldwide between 1928 to 2009 [2]. The study authors found an additional 20 published reports in the literature between 2009 to 2019, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], with two retrospective institutional reviews [15,16]. Additionally, Surov et al conducted a comprehensive review of prior case reports and patients at their institution between 1997-2009, finding that 15% of breast plasmacytomas were primary lesions while 85% involved multiple myeloma [23].…”

Section: Etiology and Demographicsmentioning

confidence: 99%

“…Additionally, Surov et al conducted a comprehensive review of prior case reports and patients at their institution between 1997-2009, finding that 15% of breast plasmacytomas were primary lesions while 85% involved multiple myeloma [23]. Thus, breast plasmacytomas can occur in the absence of multiple myeloma [14], in active multiple myeloma [18], and in relapsing multiple myeloma [20]. Notable reported cases include the involvement of breast implants [22] and diagnosis in a male patient [8].…”

Section: Etiology and Demographicsmentioning

confidence: 99%

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Extramedullary Plasmacytoma of the breast in a patient with Multiple Myeloma

Vong¹,

Navarro²,

Darrow³

et al. 2020

Radiology Case

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Extramedullary plasmacytoma of the breast is rare. It is important to recognize the imaging findings and include it as a differential consideration in multiple myeloma patients with a breast mass. A 74-year-old woman undergoing chemotherapy for relapsed multiple myeloma presented with a palpable mass in her right breast. A screening mammogram four months prior was unremarkable. She underwent a diagnostic right mammogram which showed two well-circumscribed hyperdense masses. An ultrasound of the right breast showed mixed echogenic masses with indistinct margins and increased vascularity. Ultrasound guided biopsy confirmed the presence of an extramedullary plasmacytoma. A follow-up whole body PET/CT demonstrated an FDG-avid right breast mass with extensive osseous metastases. CASE REPORTA 74-year-old woman undergoing chemotherapy for relapsing multiple myeloma (subtype IgG Lambda) presented to her medical oncologist with a new palpable right breast lump. A screening mammogram four months prior was interpreted as normal and given a BI-RADS Category 1 (negative) final assessment (Figure 1). Kappa free light chains were significantly decreased at 0.17 mg/dL (normal 0.33 -1.94 mg/dL) and Lambda free light chains were significantly elevated at 197 mg/dL (normal 0.57 -2.63 mg/dL). Clinically, the patient had persistent whole-body aches, oral bleeding, and bone pain. The patient was then referred to the breast imaging service for further work-up. She underwent a diagnostic right mammogram which showed two well-circumscribed hyperdense massesthere were no suspicious calcifications, nipple retraction, skin thickening, or areas of architectural distortion (Figure 2). A same-day ultrasound demonstrated two mixed echogenic masses with ill-defined margins and increased vascularity (Figure 3). Primary differential considerations included plasmacytoma and primary breast cancer. Hematoma was initially considered as the patient was on anticoagulation for deep venous thrombosis prophylaxis. However, given the presence of vascularity, it was deemed unlikely. An infectious etiology (i.e., breast abscess) was also considered given the rapid increase in size over four months. This was thought to be unlikely with no clinical signs of infection and central rather than peripheral vascularity. A microscopic examination of an ultrasound guided biopsy yielded plasma cell neoplasm (Figure 5). A follow-up PET/CT

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Single organ microenvironment and the common features of tumors of leukemia, lymphoma, and myeloma cells growing there: A literature review

Cunningham

Sosa²,

Hamele‐Bena

2021

European J of Haematology

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The tumor manifestations of leukemia, lymphoma, and multiple myeloma in body organs have been described for over a century.While the natural histories of each type of solid tumor is well known, that of hematologic tumors in the same organ site have not been elucidated. Knowledge of hematologic tumors has been limited to their description in individual case reports of tumors in any organ.The natural history of hematologic tumors in individual sites and their metastatic patterns has not been tracked, except for tumors at a few sites. Similar patterns of growth and spread between leukemic and solid tumors in breast, ovary, and GI sites were revealed. [1][2][3] Extensive studies of leukemic breast tumors and specimen analyses found histologic and genetic similarities of leukemic to solid breast cancers. 4 The present literature review was undertaken to ascertain

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Primary Plurifocal Extramedullary Plasmacytoma of Breast

Cited by 3 publications

References 0 publications

Extramedullary plasmacytoma: Tumor occurrence and therapeutic concepts—A follow‐up

Extramedullary plasmacytoma: Tumor occurrence and therapeutic concepts—A follow‐up

Extramedullary Plasmacytoma of the breast in a patient with Multiple Myeloma

Single organ microenvironment and the common features of tumors of leukemia, lymphoma, and myeloma cells growing there: A literature review

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