Provincial Health Services Authority (PHSA) improves the health of British Columbians by seeking province-wide solutions to specialized health care needs in collaboration with BC health authorities and other partners.
Updated 28 July 2008
The location of the solitary plasmacytoma is crucial to predicting its natural history. The majority of patients with extra-osseous (non-bone-involving) plasmacytoma have localized disease which is potentially curable with irradiation. The majority of patients with solitary plasmacytoma of bone will eventually manifest overt multiple myeloma.
All these criteria must be present:
A serum and/or urine monoclonal paraprotein may be present. Usually the uninvolved immunoglobulin levels are normal.
Solitary extra-osseous plasmacytoma
CBCserum creatinine, calciumserum protein electrophoresis
Every 3 months x 1 year then 6 months x 2 years then annual
Every 3 months x 1 year then 6 months
Patients with either type of plasmacytoma should have a 24 hour urine protein electrophoresis and low dose CT skeletal survey annually. Those patients with extra-osseous plasmacytomas do not require these extra tests after they have been well for 5 years.
No standard system is available. Patients should undergo all the usual tests for multiple myeloma. Imaging should include both a dedicated CT scan (neck/chest/abdomen and pelvis and low dose CT skeletal survey) and a PET/CT. CT scan of the plasmacytoma should be obtained prior to radiation therapy.
Standard treatment for solitary plasmacytoma is irradiation to the entire lesion with appropriate margins.
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