RESUMEN
Solitary bone plasmacytoma (SPB) can progress to generalized myeloma if not treated early. The elderly population is increasing and delays in diagnosis of plasma cell malignancies are frequent among them. Hyperglobulinemia of multiple myeloma (MM) plays a role in hyperviscosity syndrome (HVS). A 65-year-old woman with hypertension and diabetes mellitus was admitted due to loss of appetite, muscle weakness, breathlessness and discrete expectoration, without fever. Chest X-ray showed an abnormal shadow projection on the right lung field, while computed tomography (CT) revealed an osteolytic mass at the sixth rib. There were more than 50% of plasma cells in the bone marrow samples and high IgA levels according to serum electrophoresis. Rib plasmacytoma and overt IgA-producing myeloma with HVS were diagnosed, but treatment was unsuccessful. Case studies may enhance the awareness about this ominous condition, which may develop unnoticed, particularly in elderly patients with renal insufficiency, and can pose difficulties with diagnosis in primary care settings.
Asunto(s)
Viscosidad Sanguínea , Neoplasias Óseas/sangre , Neoplasias Óseas/complicaciones , Mieloma Múltiple/sangre , Mieloma Múltiple/complicaciones , Plasmacitoma/sangre , Plasmacitoma/complicaciones , Costillas , Anciano , Femenino , Humanos , Inmunoglobulina A , Mieloma Múltiple/inmunología , SíndromeRESUMEN
Solitary plasmocytoma is a rare plasma cell disorder as compared with multiple myeloma. In order to evaluate their relationships, the clinical findings in 51 patients with solitary plasmocytoma were analyzed. The median follow-up was 7.8 years (range 3 to 14). Twenty patients (39%) developed multiple myeloma in a average of 3.8 years. The risk factors associated with the development of multiple myeloma were an initial abnormal electrophoresis (M peak), age (less than 40 years) and an increase in beta-2-microglobulin. Although radiotherapy remains the initial treatment of solitary plasmocytoma, a careful evaluation should be performed in order to consider chemotherapy in selected patients with high risk of developing multiple myeloma.
Asunto(s)
Plasmacitoma , Análisis Actuarial , Biomarcadores de Tumor/análisis , Humanos , México/epidemiología , Mieloma Múltiple/epidemiología , Plasmacitoma/sangre , Plasmacitoma/epidemiología , Plasmacitoma/radioterapia , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Análisis de Supervivencia , Microglobulina beta-2/análisisAsunto(s)
Hemoglobina Fetal , Neoplasias/sangre , Adolescente , Adulto , Anciano , Carcinoma Broncogénico/sangre , Disgerminoma/sangre , Femenino , Hemoglobina Fetal/análisis , Hemoglobina Fetal/biosíntesis , Humanos , Masculino , Persona de Mediana Edad , Neurilemoma/sangre , Osteosarcoma/sangre , Plasmacitoma/sangre , Factores Sexuales , Teratoma/sangreRESUMEN
The seventh case of solitary plasmocytoma of the stomach is reported. It is suggested that in this case and possibly in others the tumor arose as a rare type of malignant change in a chronic peptic ulcer. The literature on extramedullary plasmocytoma of the gastro-intestinal tract is reviewed (Summary)