A case of extramedullary plasmacytoma arising from the posterior mediastinum.
ABSTRACT Plasmacytomas are a localized proliferation of plasma cells in the bone marrow, and are less frequently seen in extraosseous organs or tissues. Extramedullary plasmacytoma is a rare malignant neoplasm, and is especially uncommon when it arises from the mediastinum. Here, we report on a case of posterior mediastinal extramedullary plasmacytoma in a 64-year-old man. He was admitted with an asymptomatic right apical mediastinal mass, which was provisionally diagnosed as a neurogenic mass. However, a subsequent investigation revealed that this tumor was a rare case of IgG kappa type extramedullary plasmacytoma arising from the posterior mediastinum. The patient was treated with local radiation to the mediastinum and is doing well without further evidence of disease.
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ABSTRACT: A retrospective review is reported of 128 patients presenting with multiple myeloma and 16 patients presenting with solitary plasmacytoma. Ninety-one percent of 116 evaluable patients treated for palliation of painful bone disease received some degree of subjective pain relief. The radiation dose most frequently prescribed was between 1500 and 2000 rad. Of the 278 ports treated, only 17 (6.1%) were re-treated to the same area at a later date. There was no increase in incidence of re-treatment with lower radiation doses. Ten of the 13 patients treated for a solitary plasmacytoma with a minumum follow-up period of three years have local tumor control. The median survival in the solitary plasmacytomas is five and one-half years. Data from the literature on 27 additional solitary plasmacytomas combined with our data suggest an improved local control and a decrease in dissemination with doses greater than 5000 rad. It is concluded that low doses of radiation are usually adequate to treat painful bone lesions of multiple myeloma and doses of 5000-6500 rad in six to seven weeks are recommended for solitary plasmacytomas.Cancer 03/1980; 45(4):647-52. · 4.90 Impact Factor
- Klinicheskaia khirurgiia 11/1984;
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ABSTRACT: Patients with solitary osseous plasmacytomas (SOP) differ from those with extramedullary plasmacytomas (EMP) in that they are younger and the proportion of males is smaller. The median survival of the two groups is similar: 86.4 mo for SOP, and 100.8 mo for EMP. Progression-free survival, however, is much better for EMP. Only five EMP patients have progressed following initial radiation therapy: one developed a single bony lesion, two progressed to multiple myeloma, and two developed multiple EMP. Thus, 71% of EMP patients are progression free at 10 yr, and most deaths do not result from plasma cell neoplasia. In contrast, 13 SOP patients have progressed to develop additional osteolytic lesions, so that only 16% of SOP patients are progression free at 10 yr; death resulted from progression to multiple myeloma in most of these patients. In EMP patients the occurrence of involved lymph nodes at the time of diagnosis in seven, and initial relapse in regional nodes in three, suggest that consideration should be given to including regional lymph nodes in the radiation fields used to treat these patients.Journal of Clinical Oncology 05/1983; 1(4):255-62. · 17.88 Impact Factor