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13 - Solitary bone and extra-medullary plasmacytoma

from Section 3 - Myeloma: clinical entities

Published online by Cambridge University Press:  18 December 2013

By
Shirley D’Sa  and
Eve Gallop-Evans
Edited by
Stephen A. Schey ,
Kwee L. Yong ,
Robert Marcus  and
Kenneth C. Anderson
Stephen A. Schey
Affiliation:
Department of Haematology, King’s College Hospital, London
Kwee L. Yong
Affiliation:
Department of Haematology, University College Hospital, London
Robert Marcus
Affiliation:
Department of Haematology, King’s College Hospital, London
Kenneth C. Anderson
Affiliation:
Dana-Farber Cancer Institute, Boston
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Summary

Introduction and epidemiology

Solitary plasmacytoma, which accounts for less than 5% of plasma cell dyscrasias is characterized by a localized proliferation of malignant plasma cells in the absence of evident disease elsewhere. Such a proliferation may arise in a bone (solitary bone plasmacytoma or SBP) or an extra-medullary compartment (extramedullary plasmacytoma or EMP). Plasmacytomas may also arise in a multifocal manner without evidence of malignant plasma cells in the intervening tissues. Extra-medullary plasmacytomas may also arise in the context of multiple myeloma.

Solitary Bone Plasmacytoma

SBP may arise at any age, but the median age of onset at 55 years is 10 years younger than that for myeloma, with a 1.87:1 male to female ratio[1].

Clinical and laboratory features

In two-thirds of cases, SBP arises in the axial skeleton, including the spine (thoracic > lumbar > sacral > cervical spine), skull, ribs and sternum and, in one-third, the appendicular skeleton, including the shoulder girdle, pelvic girdle or the extremities [2]. Localized skeletal pain due to the solitary osteolytic lesion is a typical presentation of SBP. If the spine is affected, spinal cord or nerve root compression may be an important clinical consequence. Other presentations include pathological fracture of the affected bone, a soft tissue mass due to extra-medullary extension of the tumor and in a small proportion, symptoms of peripheral neuropathy.

Type
Chapter
Information
Myeloma
Pathology, Diagnosis, and Treatment
 , pp. 167 - 173
Publisher: Cambridge University Press
Print publication year: 2013

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References

Ozsahin, M., Tsang, R. W., Poortmans, P. et al. Outcomes and patterns of failure in solitary plasmacytoma: a multicenter Rare Cancer Network study of 258 patients. Int. J. Radiat. Oncol. Biol. Phys. 2006;64(1):210–17.CrossRefGoogle ScholarPubMed
Bataille, R., Sany, J.Solitary myeloma: clinical and prognostic features of a review of 114 cases. Cancer 1981;48(3):845–51.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Dingli, D., Kyle, R. A., Rajkumar, S. V. et al. Immunoglobulin free light chains and solitary plasmacytoma of bone. Blood 2006;108(6):1979–83.CrossRefGoogle ScholarPubMed
Wilder, R. B., Ha, C. S., Cox, J. D. et al. Persistence of myeloma protein for more than one year after radiotherapy is an adverse prognostic factor in solitary plasmacytoma of bone. Cancer 2002;94(5):1532–7.CrossRefGoogle ScholarPubMed
Rawstron, A. C., Orfao, A., Beksac, M. et al. Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders. Haematologica 2008;93(3):431–8.CrossRefGoogle ScholarPubMed
Dimopoulos, M., Kyle, R., Fermand, J. P. et al. Consensus recommendations for standard investigative workup: report of the International Myeloma Workshop Consensus Panel 3. Blood 2011;117(18):4701–5.CrossRefGoogle ScholarPubMed
Moulopoulos, L. A., Dimopoulos, M. A., Weber, D. et al. Magnetic resonance imaging in the staging of solitary plasmacytoma of bone. J. Clin. Oncol. 1993;11(7):1311–15.CrossRefGoogle ScholarPubMed
Chargari, C., Vennarini, S., Servois, V. et al. Place of modern imaging modalities for solitary plasmacytoma: Toward improved primary staging and treatment monitoring. Crit. Rev. Oncol. Hematol. (in press).
Horger, M., Weisel, K., Horger, W. et al. Whole-body diffusion-weighted MRI with apparent diffusion coefficient mapping for early response monitoring in multiple myeloma: preliminary results. AJR Am. J. Roentgenol. 2011;196(6):W790–5.CrossRefGoogle ScholarPubMed
Nanni, C., Rubello, D., Zamagni, E. et al. 18F-FDG PET/CT in myeloma with presumed solitary plasmocytoma of bone. In Vivo 2008;22(4):513–17.Google Scholar
Haznedar, R., Aki, S. Z., Akdemir, O. U. et al. Value of (18)Fluorodeoxyglucose uptake in positron emission tomography/computed tomography in predicting survival in multiple myeloma. Eur. J. Nucl. Med. Mol. Imaging 2011;55:1738–9.Google Scholar
Hill, Q., Rawstron, A. C., Child, J. A., De Tute, R., Owen, R. G.Neoplastic plasma cells are demonstrable at bone marrow sites distant to solitary plasmacytoma of bone and predict for progression to multiple myeloma. Br. J. Haematol. 2007;137(suppl. 1):18.Google Scholar
Knobel, D., Zouhair, A., Tsang, R. W. et al. Prognostic factors in solitary plasmacytoma of the bone: a multicenter Rare Cancer Network study. BMC Cancer 2006;6:118.CrossRefGoogle ScholarPubMed
Tsang, R. W., Gospodarowicz, M. K., Pintilie, M. et al. Solitary plasmacytoma treated with radiotherapy: impact of tumor size on outcome. Int. J. Radiat. Oncol. Biol. Phys. 2001;50(1):113–20.CrossRefGoogle Scholar
Dagan, R., Morris, C. G., Kirwan, J., Mendenhall, W. M.Solitary plasmacytoma. Am. J. Clin. Oncol. 2009;32(6):612–17.CrossRefGoogle ScholarPubMed
Galieni, P., Cavo, M., Avvisati, G. et al. Solitary plasmacytoma of bone and extramedullary plasmacytoma: two different entities?Ann. Oncol. 1995;6(7):687–91.CrossRefGoogle ScholarPubMed
Shih, L. Y., Dunn, P., Leung, W. M., Chen, W. J., Wang, P. N.Localised plasmacytomas in Taiwan: comparison between extramedullary plasmacytoma and solitary plasmacytoma of bone. Br. J. Cancer 1995;71(1):128–33.CrossRefGoogle ScholarPubMed
Bolek, T. W., Marcus, R. B., Mendenhall, N. P.Solitary plasmacytoma of bone and soft tissue. Int. J. Radiat. Oncol. Biol. Phys. 1996;36(2):329–33.CrossRefGoogle ScholarPubMed
Aviles, A., Huerta-Guzman, J., Delgado, S., Fernandez, A., Diaz-Maqueo, J. C.Improved outcome in solitary bone plasmacytomata with combined therapy. Hematol. Oncol. 1996;14(3):111–17.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Holland, J., Trenkner, D. A., Wasserman, T. H., Fineberg, B.Plasmacytoma. Treatment results and conversion to myeloma. Cancer 1992;69(6):1513–17.3.0.CO;2-X>CrossRefGoogle ScholarPubMed
Delauche-Cavallier, M. C., Laredo, J. D., Wybier, M. et al. Solitary plasmacytoma of the spine. Long-term clinical course. Cancer 1988;61(8):1707–14.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Mateos, M. V., Hernández, M., Giraldo, P. et al. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N. Engl. J. Med. 2013;5: 1 Aug.Google Scholar
Dimopoulos, M. A., Moulopoulos, L. A., Maniatis, A., Alexanian, R.Solitary plasmacytoma of bone and asymptomatic multiple myeloma. Blood 2000;96(6):2037–44.Google ScholarPubMed
Reed, V., Shah, J., Medeiros, L. J. et al. Solitary plasmacytomas: outcome and prognostic factors after definitive radiation therapy. Cancer (in press).
Liebross, R. H., Ha, C. S., Cox, J. D. et al. Clinical course of solitary extramedullary plasmacytoma. Radiother. Oncol. 1999;52(3):245–9.CrossRefGoogle ScholarPubMed
Dimopoulos, M. A., Hamilos, G.Solitary bone plasmacytoma and extramedullary plasmacytoma. Curr. Treat. Options Oncol. 2002;3(3):255–9.CrossRefGoogle ScholarPubMed
Bartl, R., Frisch, B., Fateh-Moghadam, A. et al. Histologic classification and staging of multiple myeloma. A retrospective and prospective study of 674 cases. Am. J. Clin. Pathol. 1987;87(3):342–55.CrossRefGoogle ScholarPubMed
Ooi, G. C., Chim, J. C., Au, W. Y., Khong, P. L.Radiologic manifestations of primary solitary extramedullary and multiple solitary plasmacytomas. Am. J. Roentgenol. 2006;186(3):821–7.CrossRefGoogle ScholarPubMed
Strojan, P., Soba, E., Lamovec, J., Munda, A.Extramedullary plasmacytoma: clinical and histopathologic study. Int. J. Radiat. Oncol. Biol. Phys. 2002;53(3):692–701.CrossRefGoogle ScholarPubMed
Alexiou, C., Kau, R. J., Dietzfelbinger, H. et al. Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. Cancer 1999;85(11):2305–14.3.0.CO;2-3>CrossRefGoogle ScholarPubMed
Sasaki, R., Yasuda, K., Abe, E. et al. Multi-institutional analysis of solitary extramedullary plasmacytoma of the head and neck treated with curative radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. (in press).
Creach, K. M., Foote, R. L., Neben-Wittich, M. A., Kyle, R. A.Radiotherapy for extramedullary plasmacytoma of the head and neck. Int. J. Radiat. Oncol. Biol. Phys. 2009;73(3):789–94.CrossRefGoogle ScholarPubMed
Tournier-Rangeard, L., Lapeyre, M., Graff-Caillaud, P. et al. Radiotherapy for solitary extramedullary plasmacytoma in the head-and-neck region: A dose greater than 45 Gy to the target volume improves the local control. Int. J. Radiat. Oncol. Biol. Phys. 2006;64(4):1013–17.CrossRefGoogle ScholarPubMed
Katodritou, E., Kartsios, C., Gastari, V. et al. Successful treatment of extramedullary gastric plasmacytoma with the combination of bortezomib and dexamethasone: first reported case. Leuk. Res. 2008;32(2):339–41.CrossRefGoogle ScholarPubMed
Varettoni, M., Mangiacavalli, S., Zappasodi, P. et al. Efficacy of Bortezomib followed by local irradiation in two patients with extramedullary plasmacytomas. Leuk. Res. 2008;32(5):839–41.CrossRefGoogle ScholarPubMed
Mendenhall, C. M., Thar, T. L., Million, R. R.Solitary plasmacytoma of bone and soft tissue. Int. J. Radiat. Oncol. Biol. Phys. 1980;6(11):1497–501.CrossRefGoogle ScholarPubMed
Boll, M., Parkins, E., O’Connor, S. J., Rawstron, A. C., Owen, R. G.Extramedullary plasmacytoma are characterized by a ‘myeloma-like’ immunophenotype and genotype and occult bone marrow involvement. Br. J. Haematol. 2010;151(5):525–7.CrossRefGoogle ScholarPubMed

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