Plasmocytoma. Report of a case

Relapse of Multiple Myeloma Presenting as Lower Lip Numbness

Multiple myeloma (MM) is an uncommon malignancy characterised by the proliferation of clonal plasma cells. There are few published reports describing the extramedullary presentation of MM manifesting primarily in the head and neck region. In addition, the occurrence of an isolated relapse of MM in these sites is exceedingly rare. We report a 56-year-old female who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2010 with sudden-onset numbness of the lower lip. She had a history of MM in remission following chemotherapy and a bone marrow transplant. Clinical and radiographic examinations were indicative of a possible relapse of MM, which was subsequently confirmed by bone marrow aspiration and histopathological evaluation. This unique case highlights the unusual site of relapse of a haematolymphoid malignancy.

Spontaneous regression of extramedullary plasmacytoma--a case report

A case of extramedullary plasmacytoma in the soft tissues of the posterior chest wall of an 80-year old man is reported herein. Immunofluorescence study showed that the tumor cells produced IgG lambda. An M-component was also detected in the patient's serum by paper electrophoresis. Two months following the open biopsy done to establish diagnosis, the tumor underwent spontaneous regression and the M-component in the serum also disappeared. This is the first case report of spontaneous regression of an extramedullary plasmacytoma and the probable reasons for this spontaneous regression are discussed herein.

Solitary plasmacytoma. I: Extramedullary soft tissue plasmacytoma

The details of 16 patients with extramedullary plasmacytoma are presented. All but one presented with localized disease, and all were treated successfully by radiotherapy. Only one patient developed local recurrence and only one has developed disseminated disease. Radiotherapy is recommended as the primary treatment of choice for these localized radiosensitive tumors. It is suggested that the good prognosis of plasmacytomas of the head and neck, in contrast to plasmacytomas arising at other sites, is related to the observation that a high proportion of these tumors are localized at the time of diagnosis and that very large primary tumors are uncommon.

Nonepithelial tumors of the nasal cavity, paranasal sinuses and nasopharynx. A clinicopathologic study. IX. Plasmacytomas

Plasmacytomas occasionally may arise in extraosseous sites, of which the upper respiratory tract is the most common. In our series of 256 nonepithelial tumors involving the nasal cavity, paranasal sinuses and nasopharynx, 10 (4%) were apparently primary extramedullary plasmacytomas. Of our patients with adequate follow-up information, four died of disseminated disease 2, 4, 5 and 6 years after the initial diagnosis. One was alive 6 years after diagnosis with locally persistent tumor. Another was living without recurrence 12 years later. Based on our findings and on the cases reported in the literature, extramedullary plasmacytomas arising in the head and neck area may evolve into one of several different patterns. 1) Some patients have localized disease which is apparently controlled (by surgery, radiotherapy or both) and which never recurs locally or becomes disseminated. 2) In some cases, the tumor recurs locally and is controlled by further therapy. 3) Other patients have a locally persistent and aggressive lesion which cannot be eradicated and which eventually leads to the patient's death by uncontrolled local growth. 4) Still other patients eventually develop evidence of plasma cell neoplasms elsewhere in the body and/or multiple myeloma.

Two cases of plasmacytoma in the oral cavity

Two cases of plasmacytoma in the oral cavity are described. The first case was a plasmacytoma of the palate in a 64-year-old man, which be an oral manifestation of multiple myeloma, with fatal course 17 months after the first examination. The second was a plasmacytoma in a 43-year-old man, manifesting first in the mandible. A review of the recent Japanese dental literature was made: 14 cases were found in the literature exhibiting evidence of plasmacytoma in the oral region. Eight of these patients had oral manifestations of multiple myeloma (IgG myeloma, 3; IgA myeloma, 1; IgD myeloma, 1; B-J myeloma, 1; undetermined, 2). The other six cases were single lesions of plasmacytoma. The ratio of males to females was 1:1. The mandible was more frequently involved than the other oral structures. The site of predilection was the posterior portion of swelling and, less frequently, pain. Surgical treatment was favored in single lesions of plasmacytoma, while in myeloma chemotherapy and a combination of radiotherapy-chemotherapy constituted 75% of treatment.