Multimodality Imaging Findings in Cardiac Plasmacytoma

Area of Science:

• Cardiology
• Oncology
• Hematology

Background:

• Extramedullary plasmacytoma is a rare plasma cell neoplasm occurring outside the bone marrow.
• Cardiac involvement by extramedullary plasmacytoma is exceptionally uncommon.
• This case highlights a rare presentation of cardiac plasmacytoma in a patient with relapsed multiple myeloma.

Observation:

• A 74-year-old male presented with dyspnea due to a solitary extramedullary plasmacytoma infiltrating the right ventricle.
• Diagnostic workup revealed no evidence of systemic multiple myeloma involvement.
• Multimodal imaging was crucial for characterizing the cardiac mass and guiding management.

Findings:

• The patient was diagnosed with cardiac plasmacytoma, a rare cardiac mass.
• The tumor extensively infiltrated the right ventricle, causing mild symptoms.
• No systemic spread of the disease was detected at the time of diagnosis.

Implications:

• This case underscores the importance of considering rare diagnoses like cardiac plasmacytoma in patients with hematologic malignancies.
• Effective treatment with a combination regimen (daratumumab, lenalidomide, and dexamethasone) was demonstrated.
• Multimodal imaging plays a vital role in the accurate diagnosis and management of cardiac tumors.