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Metachronous solitary plasmacytoma
Robin Khosa1, Shishir Seth2, Sapna Nangia1
1Radiation Oncology, Apollo Cancer Institute, Indraprastha Apollo Hospital, New Delhi, Delhi, India.
BMJ Case Reports
|October 22, 2017
Summary
Solitary plasmacytoma, a rare plasma cell neoplasm, can uncommonly relapse as new lesions without systemic disease. This case highlights successful management of multiple relapses with immune modulatory agents.
Area of Science:
- Oncology
- Hematology
- Neurology
Background:
- Solitary plasmacytoma (SP) is a rare plasma cell neoplasm, accounting for 5%-10% of all cases.
- Progression to multiple myeloma is the typical relapse pattern, while new lesions without systemic disease are rare (<2%).
Observation:
- A 46-year-old female presented with third and seventh cranial nerve palsy, diagnosed with solitary plasmacytoma.
- Initial treatment involved radiotherapy to the local site.
- The patient experienced two relapses at three distinct sites, with no evidence of systemic disease on investigations.
Findings:
- Despite multiple relapses, investigations consistently showed no evidence of systemic disease.
- Treatment with an immune modulatory agent was initiated due to recurrent disease.
- The patient achieved symptom-free status and no new lesions for over two years post-radiotherapy.
Implications:
- This case underscores the possibility of unusual relapse patterns in solitary plasmacytoma.
- Immune modulatory agents may offer a viable treatment option for refractory or relapsing solitary plasmacytoma.
- Further research into the management of rare relapse patterns in plasma cell neoplasms is warranted.
