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Case Reports
. 2022 Nov;11(11):4200-4205.
doi: 10.21037/tcr-22-1419.

Abscopal effect in a patient with solitary extramedullary plasmacytoma of the thyroid: case report

Mariko Aoyama  1 , Takashi Shono  2 , Tomohiro Inui  1 , Naoki Miyamoto  1 , Shinichi Sakamoto  1 , Seiya Inoue  1 , Satoshi Fujiwara  1 , Masakazu Goto  1 , Hiroaki Toba  1 , Hiromitsu Takizawa  1
Affiliations
Case Reports

Abscopal effect in a patient with solitary extramedullary plasmacytoma of the thyroid: case report

Mariko Aoyama et al. Transl Cancer Res. 2022 Nov.

Abstract

Background: The abscopal effect is a systemic antitumor response that occurs distant to the irradiation site and is induced by local irradiation. We herein describe a case of solitary extramedullary plasmacytoma (SEP) of the thyroid in which bone metastases disappeared after thyroidectomy and cervical radiotherapy (RT).

Case description: A 68-year-old man with a right cervical swelling for approximately 10 years visited a hospital with left elbow pain that persisted for 5 months. He was referred to our hospital for more detailed examinations and treatment. An immobile mass of approximately 10 cm in diameter was palpable on the right side of the patient's neck. Computed tomography (CT) showed osteolytic changes in the left humerus and right scapula, and a tumor in the right lobe of the thyroid gland. The patient was diagnosed with widely invasive follicular carcinoma and multiple bone metastases and underwent total thyroidectomy. During surgery, tumor infiltration into the trachea was observed. Shaving between the tumor and trachea was performed. Based on the results of a pathological examination, the patient was diagnosed with primary extramedullary plasmacytoma of the thyroid. After surgery, external beam RT was performed on the neck, which also reduced the pain in the left elbow. Positron emission tomography (PET)-CT showed the decreased accumulation of fluorodeoxyglucose (FDG) in the left humerus and right scapula, and the amelioration of osteolytic changes on CT.

Conclusions: SEP of the thyroid is rare, and to the best of our knowledge, this is the first case report in which the abscopal effect was observed after thyroidectomy and cervical RT.

Keywords: Primary solitary plasmacytoma of the thyroid; abscopal effect; case report; external beam radiotherapy (external beam RT).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tcr.amegroups.com/article/view/10.21037/tcr-22-1419/coif). HT serves as an unpaid editorial board member of Translational Cancer Research from May 2022 to April 2024. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
CT and PET-CT. CT showed a mass of approximately 10 cm in diameter in the right lobe of the thyroid gland (A; white triangles), and osteolytic changes in the left humerus (B; white triangles) and right scapula (C; white triangles). The accumulation of FDG was observed in these bones (D; white arrows). CT, computed tomography; PET, positron emission tomography; FDG, fluorodeoxyglucose.
Figure 2
Figure 2
Postoperative pathological results. Staining method: (A) H&E stain, (B) CD20, (C) CD79a, (D) CD138, (E) κ, (F) λ. Magnification: ×200, scale bar: 100 µm.
Figure 3
Figure 3
CT and PET-CT after thyroid surgery and radiation therapy to the neck. CT showed the attenuation of osteolytic changes in the left humerus (A; white triangles) and right scapula (B; white triangles). PET-CT showed a decrease in the accumulation of FDG in these bones (C). CT, computed tomography; PET, positron emission tomography; FDG, fluorodeoxyglucose.
See this image and copyright information in PMC

Comment in

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