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Case Reports
. 2013 Nov;54(5):426-30.
doi: 10.3340/jkns.2013.54.5.426. Epub 2013 Nov 30.

Rapid progression of solitary plasmacytoma to multiple myeloma in lumbar vertebra

Jin Seo Yang  1 , Yong Jun Cho  1 , Suk Hyung Kang  1 , Hyuk Jai Choi  1
Affiliations
Case Reports

Rapid progression of solitary plasmacytoma to multiple myeloma in lumbar vertebra

Jin Seo Yang et al. J Korean Neurosurg Soc. 2013 Nov.

Abstract

The prognosis of solitary plasmacytoma varies greatly, with some patients recovering after surgical removal or local fractional radiation therapy, and others progressing to multiple myeloma years later. Primary detection of progression to multiple myeloma is important in the treatment of solitary plasmacytoma. There have been several analyses of the risk factors involved in the early progression to multiple myeloma. We describe one case of solitary plasmacytoma of the lumbar vertebra that was treated with surgical decompression with stabilization and additional radiotherapy. The patient had no factors associated with rapid progression to multiple myeloma such as age, size, immunologic results, pathological findings, and serum free light chain ratio at the time of diagnosis. However, his condition progressed to multiple myeloma less than two months after the initial diagnosis of solitary plasmacytoma. We suggest that surgeons should be vigilant in watching for rapid progression to multiple myeloma even in case that the patient with solitary plasmacytoma has no risk factors for rapid progression to multiple myeloma.

Keywords: Lumbar vertebrae; Multiple myeloma; Serum free light chain; Solitary plasmacytoma.

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Figures

Fig. 1
Fig. 1
Preoperative CT (A : axial) and MRI contrast-enhanced T1-weighted images (B : axial) reveal a lytic lesion involving the right mid-posterior area of the L3 vertebral body and the right psoas muscle, and an epidural mass producing dural sac compression. Preoperative whole body PET/CT (C : coronal) shows a right paravertebral soft tissue mass with mildly increased FDG-tracer uptake, and no metastases.
Fig. 2
Fig. 2
Postoperative plain X-ray after surgical decompression with stabilization (anterior to posterior) reveals expandable interbody cage and posterior pedicle screw fixation L1/2/4.
Fig. 3
Fig. 3
Postoperative immunohistochemical staining of resected mass (A : Immunoglobulin restriction, B : CD138) shows Ig Kappa chain restriction and CD138 positive reaction.
Fig. 4
Fig. 4
A repeated PET/CT reveals disseminated multiple bony lytic lesions with increased FDG uptake.
See this image and copyright information in PMC

References

    1. Bertanha F, Boufelli G, de Camargo OP, Baptista AM, Caiero MT, de Oliveira CR, et al. Oncologic progression of bone plasmacytomas to multiple myeloma. Clinics (Sao Paulo) 2006;61:139–146. - PubMed
    1. Brivio F, Gilardi R, Bucocev R, Ferrante R, Rescaldani R, Vigoré L, et al. Surgery-induced decline in circulating dendritic cells in operable cancer patients : a possible explanation of postoperative immunosuppression. Hepatogastroenterology. 2000;47:1337–1339. - PubMed
    1. Cappuccio M, De Iure F, Gasbarrini A, Bandiera S, Boriani S. Solitary plasmacytoma of the spine : a 22 years follow-up case report. Eur Rev Med Pharmacol Sci. 2006;10:251–256. - PubMed
    1. Chakraborti C, Miller KL. Multiple myeloma presenting as spinal cord compression : a case report. J Med Case Rep. 2010;4:251. - PMC - PubMed
    1. Dimopoulos M, Kyle R, Fermand JP, Rajkumar SV, San Miguel J, Chanan-Khan A, et al. Consensus recommendations for standard investigative workup : report of the International Myeloma Workshop Consensus Panel 3. Blood. 2011;117:4701–4705. - PubMed

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