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Published on: January 14, 2014
[Renal plasmacytoma. Report of a new case]
A Tejido Sánchez1, E Hernández Martínez, M C Ortíz
1Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España.
Insights
This case study highlights a rare kidney extramedullary plasmacytoma. Early detection of paraproteins and plasmatic cell dyscrasia is crucial for suspected renal plasmacytoma.
Area of Science:
- Nephrology
- Oncology
- Hematology
Background:
- Extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm.
- Renal involvement by EMP is exceptionally uncommon.
- This case focuses on EMP localized within the kidney.
Observation:
- A 59-year-old patient presented with a renal mass and acute kidney injury.
- Diagnostic workup revealed a lambda monoclonal protein in serum and urine.
- Renal biopsy was essential for definitive diagnosis, differentiating it from renal carcinoma.
Findings:
- The patient was diagnosed with extramedullary plasmacytoma of the kidney.
- Treatment involved polychemotherapy.
- Despite treatment, the patient succumbed to rapidly progressing plasmatic cell dyscrasia within one year.
Implications:
- Renal plasmacytoma diagnosis requires high suspicion in patients with paraproteinemia and a history of plasma cell dyscrasia.
- Optimal treatment strategies for renal plasmacytoma are not standardized, with options including surgery, radiotherapy, and chemotherapy.
- This case underscores the importance of considering rare diagnoses in renal pathology.
Objective:
To present a case of extramedullary plasmacytoma localized in the kidney. The clinical features, diagnostic tests, treatment and outcome are discussed.
Methods/Results:
A 59-year-old patient presented with a right renal mass and renal failure. The complementary tests showed a lambda monoclonal band in blood and urine, and a left renal biopsy showed changes compatible with myeloma. The definitive diagnosis of plasmacytoma was based on the findings of open renal biopsy since fine needle punction findings were compatible with a carcinoma. The patient received polychemotherapy, but died one year after the diagnosis due to a rapidly progressing plasmatic cell dyscrasia.
Conclusion:
Renal plasmacytoma is rare and should be suspected when paraprotein is detected in blood and urine, and when the patient has a history of plasmatic cell dyscrasia. There is no widely-established treatment. Surgery, radiotherapy or chemotherapy, alone or in combination, can be utilized.