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Solitary Plasmacytoma

Solitary Plasmacytoma

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.​

1. Diagnosis

All these criteria must be present:

  • Biopsy proof of a plasma cell tumour
  • No lytic bone lesions except the tumour itself
  • Bone marrow plasma cell proportion less than 10%
  • For solitary plasmacytoma of bone: no significant PET scan or CT scan abnormality at another site

A serum and/or urine monoclonal paraprotein may be present. Usually the uninvolved immunoglobulin levels are normal.​​

2. Follow-up

Solitary extra-osseous plasmacytoma

​Tests

Interval

CBC
serum creatinine, calcium
serum protein electrophoresis

Every 3 months x 1 year then 6 months x 2 years then annual

Tests

Interval

CBC
serum creatinine, calcium
serum protein electrophoresis

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.​

3. Staging

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.

4. Treatment

Standard treatment for solitary plasmacytoma is irradiation to the entire lesion with appropriate margins.

SOURCE: Solitary Plasmacytoma ( )
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