The First Description of an Extramedullary Plasmacytoma of the Ureter

Klein, Tobias; Holz, Alexander; Neid, Matthias; Hinkel, Andreas; Noldus, Joachim

doi:10.1159/000273481

Cited by 9 publications

(7 citation statements)

References 14 publications

(20 reference statements)

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“…The diagnosis of EMP depends upon the demonstration of an extramedullary plasma cell tumor with no evidence of systemic signs and symptoms associated with multiple myeloma. [2] About 80% to 90% of EMP cases involve the mucosa-associated lymphatic tissue of the upper respiratory tract, and 75% of them appear in the nasal and paranasal regions [8] ; only a few cases of EMP in the kidney have been reported in the literature. [4][5][6] To the best of our knowledge, the present study describes the first case of a solitary kidney EMP in an HIV-positive patient.…”

Section: Discussionmentioning

confidence: 99%

Extramedullary plasmacytoma of the kidney in an HIV-positive patient

Li¹,

Wang

Yan³

et al. 2019

Medicine

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Rationale: Extramedullary plasmacytoma (EMP) is a very rare malignant neoplasm arising from clonal proliferation of atypical plasma cells. Most EMPs involve mucosal lymphoid tissue, particularly in the nasopharyngeal area, respiratory tract, and head and neck region. Such neoplasms of the kidney in patients with a human immunodeficiency virus (HIV) infection are extremely rare.Patient concerns: A 55-year-old male who had been diagnosed with HIV 1 year previously presented with a 2-week history of intermittent right abdominal pain and gross hematuria.Diagnosis: Ultrasonography and computed tomography detected a mass that occupied the upper half of the right kidney. A clinical diagnosis of a renal tumor was suspected.Interventions: The patient subsequently underwent a retroperitoneal radical nephrectomy. The postoperative pathological diagnosis was solitary EMP of the kidney. Adjuvant radiation therapy was provided at doses of 50 Gy in 20 fractions.Outcomes: Currently, the patient is alive and disease free at 7 months postoperatively. To the best of our knowledge, this is the first case of a primary renal EMP in a patient with HIV. Conclusion:The present case illustrates that this rare type of solitary EMP associated with acquired immune deficiency syndrome can occur in the kidney. Additionally, although rare, solitary EMP should be considered in the differential diagnosis of a renal mass in HIV-infected patients.Abbreviations: IDS = acquired immune deficiency syndrome, CT = computed tomography, EMP = extramedullary plasmacytoma, HIV = human immunodeficiency virus.

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Section: Discussionmentioning

confidence: 99%

Extramedullary plasmacytoma of the kidney in an HIV-positive patient

Li¹,

Wang

Yan³

et al. 2019

Medicine

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“…The main sites of EMP are the upper respiratory tract and upper gastrointestinal tract, both accounting for approximately 80% of cases. The ureter is an extremely rare site of EMP, and only 3 cases, including the present case, have been reported in the literature (Table 1 ) [ 2 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Radiographic images such as CT or magnetic resonance imaging may be useful, but a ureteral mass is nonspecific. Bone marrow biopsies and fine needle aspirations as well as urine and blood tests are obligatory [ 3 ]. However, there is no standard treatment for EMP of the ureter.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical excision, radiotherapy, chemotherapy, or combined surgery and radiotherapy are considered. Landsmann et al [ 2 ] reported that they conducted segmental removal of the affected ureter and ureterocystostomy, but Klein et al [ 3 ] reported that nephroureterectomy was performed because of a suspected diagnosis of a transitional cell carcinoma of the ureter. We performed nephroureterectomy in our case, because the ureteral mass on the CT scan was definitive for urothelial carcinoma and urine cytology findings were pseudo-positive.…”

Section: Discussionmentioning

confidence: 99%

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Extramedullary plasmacytoma of the ureter in an HIV-positive patient

et al. 2017

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A 45-year-old Japanese man, who was undergoing HIV infection treatment, was aware that he had gross hematuria, and he was diagnosed as having a ureteral tumor by radiographic examination. Therefore, he was referred to our department for further examination and treatment. We considered that the ureteral tumor was a urothelial carcinoma (cT2N0M0) because of the left ureteral tumor and urine cytology results, and thus, laparoscopic ureteronephrectomy was performed. The pathological diagnosis was a solitary extramedullary plasmacytoma (EMP) of the ureter. Currently, he is alive and free of disease at 7 months postoperatively. EMP develops in the nasal cavity, paranasal cavity, gastrointestinal tract, lung, thyroid, eye socket, lymph node, and various organs, but the ureter is an extremely rare site of EMP. In addition, the patient had an HIV infection. To the best of our knowledge, this is the first case of EMP of the ureter in an HIV-positive patient.

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“…EMP accounts for 3-5% of all plasma cell tumors, with an incidence of only 0.04 cases per 100,000 individuals (2). Approximately 80% of EMPs occur in the upper respiratory tract (3), but they can also occur in numerous other sites (3,4), including the gastrointestinal tract (5,6), brain (7), orbits (8), thyroid gland (9), breasts (10), lungs (11), pleura (12), kidneys (13),bladder (14), urethra (15), ovaries (16), testes (17) and skin (18). Usually, EMPs have no specific clinical manifestations.…”

Section: Introductionmentioning

confidence: 99%

Irradiation combined with surgery for function preservation in the treatment of extramedullary plasmacytoma of the left labia majora during pregnancy: A case report

Zhang

Shen

et al. 2015

Oncology Letters

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Abstract. Extramedullary plasmacytoma (EMP) in the vulva is extremely rare. The current study presents, for the first time, a case of EMP in the left labia majora in a 36-year-old patient during pregnancy. A painful 7x4x2-cm mass with ulceration, pus and blood scabs, previously misdiagnosed as vulvar ulcer in a local hosipital, was proven to be an EMP by biopsy. Upon magnetic resonance imaging, the tumor was shown to occur in the left labia majora without lymphadenopathy. A complete multiple myeloma (MM) workup excluded coexistence with MM. The goal of treatment was to eradicate the tumor while synchronously preserving the vulva. Therefore, following the termination of the pregnancy, radiotherapy with a total dose of 4,500 cGy markedly reduced the size of the tumor. An extended local excision of the residual tumor, and anaplasty of the vulva preserved the appearance and function of the vulva to the utmost. No post-operative radiation was administered, as the resection margins were not microscopically involved. There was no relapse, metastasis or progression to MM in a 9-month post-operative follow-up period, but close follow-up and long-term surveillance are required.

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The First Description of an Extramedullary Plasmacytoma of the Ureter

Cited by 9 publications

References 14 publications

Extramedullary plasmacytoma of the kidney in an HIV-positive patient

Extramedullary plasmacytoma of the kidney in an HIV-positive patient

Extramedullary plasmacytoma of the ureter in an HIV-positive patient

Irradiation combined with surgery for function preservation in the treatment of extramedullary plasmacytoma of the left labia majora during pregnancy: A case report

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