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Extramedullary plasmacytoma presenting as a mediastinal mass
Arpana Shukla, Vivek Bansal, Ritu Bhutani1
1Rajiv Gandhi Cancer Institute and Research Centre, Department of Radiation Oncology, Sector V, Rohini 110085 Delhi, India Phone: 91-11-47022222
Summary
This study presents a rare case of mediastinal extramedullary plasmacytoma (EMP). Radiotherapy proved effective for this mediastinal EMP, highlighting the need for thorough workup to rule out multiple myeloma.
Area of Science:
- Oncology
- Hematology
- Thoracic Surgery
Background:
- Extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm distinct from multiple myeloma.
- Mediastinal EMP is exceptionally uncommon, limiting large-scale clinical investigations.
- This case highlights a solitary mediastinal plasmacytoma presenting with reactive pleural effusion.
Purpose of the Study:
- To report a rare case of solitary mediastinal extramedullary plasmacytoma.
- To discuss the diagnostic and therapeutic approach for mediastinal EMP.
- To emphasize the importance of comprehensive evaluation for coexisting multiple myeloma.
Main Methods:
- Positron Emission Tomography (PET) for initial mass detection.
- CT-guided biopsy for histopathological diagnosis (IgG kappa-type EMP).
- Local radiotherapy to the mediastinum for treatment.
Main Results:
- A 58-year-old female with grade 4 dyspnea and dysphagia.
- Diagnosis of anterior mediastinal IgG kappa-type EMP confirmed by biopsy.
- Successful clinical and radiological response following mediastinal radiotherapy.
Conclusions:
- Mediastinal EMP is a rare entity requiring careful diagnosis.
- Radiotherapy is an effective treatment modality for mediastinal EMP.
- Mandatory comprehensive workup, including PET, is crucial to exclude multiple myeloma.
