Solitary plasmacytoma of the jaws: therapeutical considerations and prognosis based on a case reports systematic survey / Solitary plasmacytoma of the jaws: therapeutical considerations and prognosis based on a case reports systematic survey

Abstract Introduction: Solitary plasmacytoma is a rare malignant tumor of plasma cells with no evidence of systemic proliferation. There are two known subtypes: extramedullary solitary plasmacytoma and solitary bone plasmacytoma. The etiology is still unknown. Both lesions present a risk of progression to multiple myeloma. A number of approaches have been used for treatment of solitary plasmacytoma. Objective: To carry out a systematic review of the case reports described in the literature, focusing on therapeutic and prognostic aspects. Methods: A search of clinical case reports was performed in the PubMed database using Mesh Terms related to "plasmacytoma" under the following criteria: type of study (case report), articles in English language, conducted in humans, with no publication date limits. Results: Of the 216 articles found, only 21 articles met the pre-established inclusion criteria. Conclusion: The occurrence of solitary bone plasmacytoma in the bones of the face is a rare condition prevalent between the 4th and 6th decades of life, located in the posterior region of the mandible in most cases. Histopathological examination and systemic investigation are mandatory for confirmation of diagnosis.

Resumo: Introdução: O plasmocitoma solitário é um tumor maligno raro de células plasmáticas sem evidência de proliferação sistêmica e engloba dois subtipos: plasmocitoma solitário extramedular e plasmocitoma solitário ósseo. A etiologia ainda é desconhecida. Ambas as lesões apresentam risco de progressão para mieloma múltiplo. Uma série de abordagens tem sido usada para seu tratamento. Objetivo: Realizar uma revisão sistemática da literatura com enfoque nos aspectos terapêuticos e prognósticos. Método: Realizou-se uma busca de relatos de caso clínico na base de dados PubMed com termos de busca relacionados com "plasmocitoma" sob os seguintes critérios: tipo de estudo (relato de caso), artigos na língua inglesa, estudos realizados apenas em humanos, sem limites de data de publicação. Resultados: Dos 216 artigos encontrados, apenas 21 preencheram os critérios de inclusão pré-estabelecidos. Conclusão: A ocorrência de plasmocitoma solitário ósseo nos ossos da face é uma condição rara prevalente entre a 4a e a 6a décadas de vida, localizada na região posterior de mandíbula na maioria dos casos. O exame histopatológico e a investigação sistêmica são mandatórios para confirmação do diagnóstico.

Surgical Treatment of Spinal Plasma Cell Tumors

OBJECTIVE: The purpose of this study is to review the cases of spinal plasma cell tumors treated in our department with regard to presenting symptoms and signs, diagnostic investigations, extent of surgical interventions, complications, survival time and influence on the quality of life. METHODS: In a retrospective study, twelve spinal plasma cell tumor patients who underwent surgery were evaluated between Oct. 1991 and Dec. 2000. Clinical staging system was evaluated by Durie-Salmon Staging System. RESULTS: There were multiple myeloma in nine and solitary plasmacytoma in three patients, six men and six women and aged 38 to 69 years(mean 56.8 years). The locations of the lesions were two cervical, two cervico-thoracic, three thoracic, one thoraco-lumbar, three lumbar and one sacral. The most common initial presenting symptom and sign were local pain and motor weakness. Radiographs showed pathologic compression fracture in six and the MRI finding were cortical infolding, focal to diffuse patterns of low-signal on T1WI, high signal intensity on T2WI, and variable of enhancement on Gadolinium enhanced T1W1. Sixteen operations were performed. and the adjuvant theraphy included radiotheraphy, chemotheraphy(combined oral melphalan and predinisone), and autologous PBST(peripheral blood stem cell transplantation). The follow-up period was three to sixty months(mean 27.0 months). The mean Karnofsky scale score was changed from 54.5 to 73.3 after follow up. One patient died of pulmonary metastasis and sepsis. CONCLUSION: Our experience suggests that treatment of spinal plasma cell tumor may be rewarding.