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Solitary Plasmacytoma

Disclaimer

  • This manual is not a substitute for consultation with an appropriate specialist.
  • The contents of this manual have been developed through consensus of a Provincial Tumour Group. Please note the various update dates for each section as some of the content of the manual may not be up to date.



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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