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1.
BMJ Case Rep ; 14(11)2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34794974

RESUMO

Multiple myeloma (MM) patients live longer due to more effective treatment, and we now see previously uncommon manifestations of MM, like extramedullary disease. We present a case of a 74-year-old man known with MM that relapsed with extramedullary manifestations at different locations. One of them as a gastric plasmacytoma (GP). He was successfully treated with chemoradiotherapy (Daratumumab, Bortezomib and Dexamethasone), which resulted in clinical response for 8 months, confirmed by biopsy and histopathology. Perforation of the GP occurred, and he underwent partial gastrectomy (Billroth II gastrojejunostomy). The patient's disease progressed again 5 months after surgery, and he did not want any additional treatment. He accepted palliative care and died 10 months after the operation. A lack of knowledge about the characteristics and treatment of extramedullary MM exists, and prospective studies to investigate incidence, prognosis and treatment for extramedullary MM are needed for improving the poor prognosis of this manifestation.


Assuntos
Mieloma Múltiplo , Plasmocitoma , Idoso , Bortezomib/uso terapêutico , Humanos , Masculino , Mieloma Múltiplo/complicações , Mieloma Múltiplo/tratamento farmacológico , Recidiva Local de Neoplasia , Estudos Prospectivos
2.
Can Vet J ; 62(10): 1077-1082, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34602635

RESUMO

A 10-year-old, intact male Siberian husky dog was presented for a suspected left renal cyst. Computed tomography (CT) identified a large, left kidney mass with retroperitoneal hemorrhage. A left-sided nephrectomy was performed, and histopathology confirmed a renal plasmacytoma. Perioperative screening for multiple myeloma was negative. The dog was lost to follow-up and was euthanized 11 months after surgery. A necropsy was not performed. To the authors' knowledge, this is the first case of renal extramedullary plasmacytoma in a dog. Key clinical message: This report describes the clinical presentation, and laboratory, diagnostic imaging, and surgery findings of a case of renal extramedullary plasmacytoma in a dog.


Assuntos
Doenças do Cão , Neoplasias Renais , Plasmocitoma , Animais , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Cães , Eutanásia Animal , Rim , Neoplasias Renais/diagnóstico , Neoplasias Renais/cirurgia , Neoplasias Renais/veterinária , Masculino , Plasmocitoma/diagnóstico , Plasmocitoma/cirurgia , Plasmocitoma/veterinária , Tomografia Computadorizada por Raios X
3.
Medicine (Baltimore) ; 100(37): e27288, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664889

RESUMO

RATIONALE: Solitary bone plasmacytoma (SBP) is a rare manifestation of plasma cell tumor. Although axial skeleton is the most frequently affected site of SBP, adjacent disc space involvement is rare. Herein we report a case of SBP in thoracic vertebra with involvement of adjacent disc space. PATIENT CONCERNS: A 57-year-old male presented with a 2-year history of intermittent back pain with activity. The patient's back pain intensity with activity was a score of 5 of the 10-point visual analog scale). DIAGNOSES AND INTERVENTION: The patient underwent a posterior fusion procedure from T6 to T10, and an open biopsy of the vertebral lesion confirmed that final diagnosis of SBP. The patient received postoperative radiotherapy with a total of 4000 Gy to the T7-T9 vertebral levels over a 20-day period. OUTCOMES: Following radiotherapy, the patient's pain intensity was reduced to the visual analog scale score of 1 at the 6-month follow-up. LESSONS: SBP lacks typical clinical symptoms, and the accurate diagnosis before clinical intervention remains challenging. Due to the disc involvement, SBP often manifests as spinal infection. Hence, differential diagnosis in spinal lesions involving the disc should include SBP.


Assuntos
Deslocamento do Disco Intervertebral/etiologia , Plasmocitoma/complicações , Coluna Vertebral/anormalidades , Dor nas Costas/etiologia , Dor nas Costas/fisiopatologia , Humanos , Deslocamento do Disco Intervertebral/fisiopatologia , Masculino , Pessoa de Meia-Idade , Plasmocitoma/fisiopatologia , Fusão Vertebral/métodos , Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
4.
J Comp Pathol ; 187: 7-10, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34503657

RESUMO

A 12-year-old castrated male Jack Russell Terrier presented with intermittent vomiting. Abdominal ultrasonographic examination detected a thickened stomach wall with a mass measuring approximately 1.5 cm in diameter. Computed tomography revealed a solitary mass measuring approximately 2.1 cm in diameter between the submucosa and muscle layers in the greater curvature the pyloric region of the stomach, and a swelling in the hepatic lymph node. The gastric mass was composed of round neoplastic cells arranged in a diffuse pattern. The neoplastic cells had a round nucleus and a pale abundant cytoplasm. Multinucleated giant cells were often found. Hyalinized eosinophilic material, which did not stain with Congo red and had no affinity for thioflavin T, was also observed. Neoplastic cells were immunopositive for MUM1, CD79a and Ig lambda light chain but negative for CD3, CD20, BLA36, IgG and Ig kappa light chain. Stromal eosinophilic material was positive for Ig lambda light chain. The neoplasm was therefore diagnosed as a gastric plasmacytoma with non-amyloid Ig lambda light chain deposition.


Assuntos
Doenças do Cão , Plasmocitoma , Neoplasias Gástricas , Animais , Cães , Cadeias lambda de Imunoglobulina , Imunoglobulinas , Masculino , Plasmocitoma/veterinária , Neoplasias Gástricas/veterinária , Tomografia Computadorizada por Raios X
5.
Rinsho Ketsueki ; 62(7): 727-732, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34349055

RESUMO

We report the case of a 62-year-old woman with multiple liver tumors. She was diagnosed with synchronous occurrence of multiple myeloma (MM) and primary pulmonary adenocarcinoma 4 years ago. She was treated with bortezomib and dexamethasone for MM, and then she underwent thoracoscopic lobectomy. After the surgery, she received autologous peripheral blood stem cell transplantation. However, recurrence of MM was observed 9 months later. She received multiple chemotherapies for MM, but the effect was limited. Meanwhile, brain metastasis of pulmonary adenocarcinoma was observed; therefore, she underwent surgical resection and received radiation therapy. Furthermore, she had elevated levels of liver enzymes, and ultrasonography revealed multiple liver tumors. Because of thrombocytopenia, liver biopsy could not be performed, and chemotherapies for MM did not improve the tumors. Therefore, we clinically determined that the liver tumors were metastatic pulmonary adenocarcinomas. The epidermal growth factor receptor mutation was present in the pulmonary adenocarcinoma, so gefitinib was administered. However, the tumors were uncontrollable and the patient died within 1 month. From autopsy, the liver lesion was confirmed to be MM. Synchronous occurrence of MM and other primary cancers is very rare, and no standard treatment has yet been established. Thus, it is crucial to accumulate synchronous cases and develop treatment methods in the future.


Assuntos
Adenocarcinoma , Mieloma Múltiplo , Plasmocitoma , Feminino , Humanos , Fígado , Pessoa de Meia-Idade , Mieloma Múltiplo/terapia , Recidiva Local de Neoplasia
6.
Cancer Radiother ; 25(6-7): 603-606, 2021 Oct.
Artigo em Francês | MEDLINE | ID: mdl-34462212

RESUMO

The management of myeloid and lymphoid disease is essentially based on chemotherapy and targeted therapies. Since radiotherapy could be responsible for severe late toxicities, essentially due to conventional bidimensional irradiation techniques, many trials have attempted to omit radiotherapy or to scale down the dose in their therapeutic strategy. Nevertheless, radiotherapy still plays a role for curative or symptomatic purposes.


Assuntos
Leucemia/radioterapia , Linfoma/radioterapia , Neoplasias Cutâneas/radioterapia , Doença Aguda , Doença de Hodgkin/patologia , Doença de Hodgkin/radioterapia , Humanos , Leucemia/patologia , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/radioterapia , Mieloma Múltiplo/radioterapia , Plasmocitoma/radioterapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapia , Sarcoma/radioterapia , Neoplasias Cutâneas/patologia
7.
BMC Neurol ; 21(1): 303, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34362322

RESUMO

BACKGROUND: Plasmacytomas are rare tumors comprised of neoplastic monoclonal plasma cells and can be found anywhere in the body. Plasmacytomas that involve the nervous system can give rise to diffuse symptoms depending on their location. Patients with confusion or dementia might be difficult to neurologically assess in an acute setting and the subtle symptoms of neurological pathology caused by rare malignancies might go undiagnosed. CASE PRESENTATION: The patient is an 80 year old man presenting to the ER with walking difficulties, pain, and confusion. He underwent neurological evaluation for dementia and was eventually diagnosed with possible Alzheimer's disease and a malignant plasmacytoma causing spinal cord compression. His CSF sample showed normal amyloid rate and very low Aß. Following rehabilitation and oncological treatment, his walking ability and confusion improved. CONCLUSION: This case is unique as we demonstrate that spinal cord compression by plasmacytoma can lead to abnormal CSF levels of several known pathology markers for Alzheimer's disease and neuronal damage. We suggest that highly divergent amyloid CSF levels could be indicative of spinal pathologies affecting CSF circulation. We also suggest closer assessment of elderly confusion patients in ER settings by consultants specialized in neurological disorders.


Assuntos
Disfunção Cognitiva , Plasmocitoma , Compressão da Medula Espinal , Idoso de 80 Anos ou mais , Doença de Alzheimer , Biomarcadores , Humanos , Masculino , Plasmocitoma/complicações , Compressão da Medula Espinal/diagnóstico por imagem , Compressão da Medula Espinal/etiologia
9.
Head Neck ; 43(10): E46-E50, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34272912

RESUMO

BACKGROUND: Extramedullary plasmacytomas are tumors that develop from plasma cells and rarely express anaplastic features. To our knowledge, there have only been three reported cases of anaplastic plasmacytomas of the sinonasal tract in the English literature. We detail the fourth case. METHODS: A 70-year-old male was seen with a 4-month history of nasal congestion, bloody mucous, and left sided nasal obstruction. On positron emission tomography/computed tomography, the lesion was FDG-avid with an SUVmax of 25.1. A biopsy of the lesion and subsequent immunohistochemical staining confirmed the diagnosis of an anaplastic plasmacytoma. RESULTS: The patient is undergoing a 5-week course of curative-intent radiation therapy. CONCLUSION: Extramedullary plasmacytomas with anaplastic features are very rare. We highlight the value of thorough histopathological review and detailed immunostains to arrive at a diagnosis of anaplastic extramedullary plasmacytoma.


Assuntos
Seios Paranasais , Plasmocitoma , Idoso , Biópsia , Humanos , Masculino , Plasmocitoma/radioterapia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
10.
PLoS One ; 16(7): e0253025, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34242226

RESUMO

Accurate staging and evaluation of therapeutic effects are important in managing plasma-cell neoplasms. Diffusion-weighted imaging with body signal suppression magnetic resonance imaging (DWIBS-MRI) allows for acquisition of whole-body volumetric data without radiation exposure. This study aimed to investigate the usefulness of DWIBS-MRI in plasma-cell neoplasms. We retrospectively analyzed 29 and 8 Japanese patients with multiple myeloma and monoclonal gammopathy of undetermined significance, respectively, who underwent DWIBS-MRI. We conducted a histogram analysis of apparent diffusion coefficient values. The correlations between each histogram parameter and staging, cell maturation, prognosis, and treatment response were evaluated. We found that the apparent diffusion coefficient values in patients with monoclonal gammopathy of undetermined significance were lower than those in patients with multiple myeloma. Pretreatment apparent diffusion coefficient values of immature myeloma were lower than those of mature myeloma. Moreover, these values decreased in proportion to stage progression in Durie-Salmon classification system but showed no significant correlation with other staging systems or prognosis. Patients were stratified as responder, stable, and non-responder based on the International Myeloma Working Group criteria. The magnitude of changes in apparent diffusion coefficients differed significantly between responders and non-responders (0.154 ± 0.386 ×10-3 mm2/s vs. -0.307 ± 0.424 ×10-3 mm2/s, p = 0.003). Although its usefulness has yet to be established, DWIBS-MRI combined with apparent diffusion coefficient measurement allowed for excellent response evaluation in patients with multiple myeloma. Furthermore, apparent diffusion coefficient analysis using DWIBS-MRI may be useful in predicting cell maturation and total tumor volume.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Estadiamento de Neoplasias/métodos , Neoplasias de Plasmócitos/patologia , Imagem Corporal Total/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Gamopatia Monoclonal de Significância Indeterminada/patologia , Mieloma Múltiplo/patologia , Plasmocitoma/patologia , Prognóstico , Estudos Retrospectivos
12.
Rev. Soc. Odontol. La Plata ; 31(60): 23-26, jul. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1284468

RESUMO

Las neoplasias malignas de la cavidad oral en gran medida (90%) consisten en carcinoma de células escamosas que surgen de la mucosa de revestimiento. El 10% restantes de neoplasias malignas orales de un grupo heterogéneo de tumores de diferente etiología. Presentamos dos casos de patología oncohematológica: Mieloma Múltiple (AU)


Malignant neoplasms of the oral cavity largely (90%) consist of squamous cell carcinoma arising from the lining mucosa. e remaining 10% of oral malignancies from a heterogeneous group of tumors of different etiology. We present two cases of oncohematological pathology: Multiple Myeloma (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Plasmocitoma/diagnóstico , Plasmocitoma/patologia , Plasmocitoma/diagnóstico por imagem , Neoplasias Bucais/diagnóstico , Radioterapia , Biópsia/métodos , Tomografia Computadorizada por Raios X , Procedimentos Cirúrgicos Bucais/métodos , Difosfonatos/uso terapêutico , Seio Maxilar/cirurgia , Mieloma Múltiplo
13.
Clin Dermatol ; 39(2): 215-219, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34272013

RESUMO

Adenopathy and an extensive skin patch overlying a plasmacytoma (AESOP) syndrome, first described 16 years ago, is characterized by a slowly expanding red or brown patch (classic variant) or plaque (morphea-like variant) overlying a solitary plasmacytoma of the bone. Early recognition can be life-saving, as it is an early presentation of polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes (POEMS) syndrome, which may be fatal. There are two forms: the classic variant, which presents as a smooth, shiny macule with abnormal visibility of skin vessels, and the morphea-like variant, which presents as a plaque where the skin is folded, giving a "peau d'orange" appearance. The locations are frequently above the rib cage, above the sternum, or the scalp. Seventy-five percent of the patients develop regional lymphadenopathy within a few months. Histopathologic study reveals a capillary proliferation in the dermis. The diagnosis relies on subsequent identification of the plasmacytoma. At the time of a presumptive diagnosis, only 40% of patients have fulfilled the diagnostic criteria of POEMS. Treatment depends on the final hematologic diagnosis, but radiation of the plasmacytoma is required.


Assuntos
Síndrome POEMS , Plasmocitoma , Humanos , Síndrome POEMS/diagnóstico , Plasmocitoma/diagnóstico
14.
Medicine (Baltimore) ; 100(26): e26568, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34190199

RESUMO

ABSTRACT: Due to the rarity of solitary bone plasmacytoma (SBP), few studies reported the prognosis and survival predictors of SBP, especially for patients with extremity SBP.A total of 552 patients with extremity SBP were identified from the Surveillance Epidemiology and Ends Results (SEER) database between 1973 and 2016. In order to obtain independent predictors of survival, we performed both univariate and multivariate analysis via Cox proportional hazards model. Additionally, we used the Kaplan-Meier method to construct survival curves.The mean and median age at diagnosis of all patients were 64 and 65 years, respectively. The ratio of male versus women was 1.3:1. Overall survival for this special population was 51.2% and 34.9% at 5 and 10 years, respectively. Cancer-specific survival (CSS) for this special population was 63.5% and 47.5% at 5 and 10 years, respectively. Age at diagnosis and radiotherapy treatment were found to be significant independent predictors of both overall survival and CSS. Additionally, multivariate analysis showed that year of diagnosis and marital status were significantly correlated with CSS.This is the first study to identify prognostic factors of extremity SBP by using the SEER database. Our findings highlight that radiotherapy is the mainstream treatment for extremity SBP. Additionally, age, year of diagnosis, and marital status were significant independent predictors of survival. Knowledge of these survival predictors may help clinicians provide appropriate management for extremity SBP patients.


Assuntos
Neoplasias Ósseas , Extremidades/patologia , Estado Civil/estatística & dados numéricos , Plasmocitoma , Radioterapia , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/patologia , Neoplasias Ósseas/radioterapia , China/epidemiologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Plasmocitoma/diagnóstico , Plasmocitoma/mortalidade , Plasmocitoma/patologia , Prognóstico , Radioterapia/métodos , Radioterapia/estatística & dados numéricos , Programa de SEER/estatística & dados numéricos
15.
Diagn Interv Imaging ; 102(10): 611-618, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34127433

RESUMO

PURPOSE: To compare conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in the differentiation of bone plasmacytoma from bone metastasis in the extremities. MATERIALS AND METHODS: A total of 65 patients with 27 bone plasmacytomas (11 men; mean age, 63.6±8.2 [SD] years) and 38 patients with bone metastases (20 men; mean age, 64.1±11.5 [SD] years) were retrospectively included. Plasmacytomas and metastases were compared for size, peritumoral edema, signal intensity (SI), SI pattern, apparent diffusion coefficient (ADC) values and standard deviation (SD) of ADC. Receiver operating characteristic analysis with area under the curve (AUC) was used to calculate sensitivity, specificity, and accuracy of MRI and DWI for the diagnosis of plasmacytoma according to a defined cut-off value. RESULTS: On conventional MRI, plasmacytomas showed less peritumoral edema (22% vs. 71%; P<0.001), were more often hyperintense on T1-weighted image (48% vs. 18%; P=0.022) and more homogeneous on T2-weighted image (78% vs. 26%; P<0.001) and contrast-enhanced T1-weighted images (70% vs. 25%; P=0.001) than bone metastases. Mean ADC value and SD of ADC were significantly lower in bone plasmacytomas (760.1±196.9 [SD] µm2/s and 161.5±62.7 [SD], respectively) than in bone metastases (1214.2±382.6 [SD] µm2/s and 277.0±110.3 [SD], respectively) (P<0.001). Using an ADC value≤908.3µm2/s, DWI yielded 88% sensitivity and 78% specificity for the diagnosis of plasmacytoma. ADC value yielded best area under the curve (AUC=0.913), followed by SD of ADC (AUC=0.814) and homogeneity on T2-weighted images (AUC=0.757). The combination of conventional MRI and DWI (AUC=0.894) showed improved diagnostic performance over conventional MRI alone (AUC= 0.843) for discriminating between plasmacytoma and metastasis. CONCLUSION: Conventional MRI in combination with DWI can be useful to discriminate between bone plasmacytoma and bone metastasis in the extremities.


Assuntos
Plasmocitoma , Idoso , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética , Extremidades , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Plasmocitoma/diagnóstico por imagem , Estudos Retrospectivos , Sensibilidade e Especificidade
16.
J Oral Pathol Med ; 50(6): 613-621, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34089204

RESUMO

BACKGROUND: Plasma cell neoplasms are characterized by the proliferation of a single clone of plasma cells with production of a monoclonal immunoglobulin. They can manifest as a single lesion (plasmacytoma) or as multiple lesions (multiple myeloma). METHODS: Paraffin-embedded tissue blocks of patients microscopically diagnosed with plasma cell neoplasms in the jaws were retrieved from five pathology files. Data including clinical, radiographic, microscopic and immunohistochemical findings, treatment employed and follow-up status were retrieved from the pathology reports. RESULTS: Fifty-two cases were retrieved (mean age: 59.4 years) without sex predilection. The mandible was the most affected site (67.3%), usually associated with pain and/or paresthesia (53.8%). Lesions in other bones besides the jaws were reported for 24 patients (46.2%). Radiographically, tumours usually presented as poorly defined osteolytic lesions with unilocular or multilocular images, while microscopy revealed diffuse proliferation of neoplastic plasma cells with nuclear displacement and abundant eosinophilic cytoplasm. Two cases were classified as anaplastic, and amyloid deposits were found in two other cases. Immunohistochemistry was positive for plasma cell markers and negative for CD20 and CD3, and monoclonality for kappa light chain predominated. The overall survival rate after 5 years of follow-up was 26.6%. CONCLUSION: Plasma cell neoplasms are aggressive tumours with a poor prognosis and involvement of the jaws may be the first complaint of the patient. Thus, oral pathologists, head and neck surgeons and dentists should be aware of their clinical, radiographic and microscopic manifestations.


Assuntos
Mieloma Múltiplo , Neoplasias de Plasmócitos , Plasmocitoma , Humanos , Imuno-Histoquímica , Arcada Osseodentária/diagnóstico por imagem , Pessoa de Meia-Idade , Mieloma Múltiplo/diagnóstico por imagem , Neoplasias de Plasmócitos/diagnóstico por imagem , Plasmocitoma/diagnóstico por imagem
17.
J Orthop Surg Res ; 16(1): 400, 2021 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-34158101

RESUMO

OBJECTIVE: To compare the efficacy and safety between denosumab and zoledronic acid for advanced cancer with bone metastasis. METHODS: MEDLINE, EMBASE, and the Cochrane library databases were searched for randomized controlled trials up to December 2020 that compared denosumab and zoledronic acid in the treatment of advanced cancer with bone metastasis. The following clinical outcomes were extracted for analysis: time to first skeletal-related event, time to first-and-subsequent skeletal-related events, overall survival, and disease progression. Safety outcomes including incidence of adverse events, serious adverse events, acute-phase reactions, renal toxicity, osteonecrosis of the jaw, and hypocalcemia were also extracted. RESULTS: Four randomized controlled trials involving 7201 patients were included. The overall analysis showed that denosumab was superior to zoledronic acid in delaying time to first skeletal-related event (hazard ratio = 0.86; 95% confidence interval, 0.80-0.93; P < 0.01) and time to first-and-subsequent skeletal-related events (risk ratio 0.87; 95% confidence interval 0.81-0.93; P < 0.01). Denosumab was associated with lower incidence of renal toxicity (risk ratio 0.69; 95% confidence interval 0.54-0.87; P < 0.01) and acute phase reaction (risk ratio 0.47; 95% confidence interval 0.38-0.56; P < 0.01), but higher incidence of hypocalcemia (risk ratio 1.78; 95% confidence interval 1.33-2.38; P < 0.01) and osteonecrosis of the jaw (risk ratio 1.41; 95% confidence interval 1.01-1.95; P = 0.04). No significant differences were found in overall survival, time to disease progression, or incidence of adverse events and serious adverse events between denosumab and zoledronic acid. CONCLUSIONS: Compared with zoledronic acid, denosumab is associated with delayed first-and-subsequent skeletal-related events, lower incidence of renal toxicity, and acute phase reaction, but higher incidence of hypocalcemia and osteonecrosis of the jaw. Hence, denosumab seems to be a promising choice for advanced cancer with bone metastasis. Nonetheless, more randomized controlled trials are needed for further evaluation.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Denosumab/uso terapêutico , Mieloma Múltiplo/tratamento farmacológico , Plasmocitoma/tratamento farmacológico , Ácido Zoledrônico/uso terapêutico , Neoplasias Ósseas/secundário , Humanos , Mieloma Múltiplo/patologia , Plasmocitoma/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
19.
Clin Nucl Med ; 46(6): 523-524, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33826570

RESUMO

ABSTRACT: 68Ga-labeled quinoline-based fibroblast activation protein inhibitors (68Ga-FAPIs) has been used in the evaluation of a variety of malignancies. We report the case of a patient with rib plasmacytoma, which showed elevated 68Ga-FAPI activity. This case indicated fibroblast activation protein overexpression and some degree of fibrosis in the plasmacytoma lesion. Therefore, 68Ga-FAPI can be a potential tracer in the evaluation of plasmacytoma.


Assuntos
Plasmocitoma/diagnóstico por imagem , Plasmocitoma/patologia , Quinolinas , Costelas/diagnóstico por imagem , Humanos , Costelas/patologia
20.
BMJ Case Rep ; 14(4)2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33888477

RESUMO

A 57-year-old man with lumbar pain and fever was diagnosed with spondylodiscitis. Afterward, he acquired full paraplegia. Image studies showed a mass extending from D9 to the vertebral canal, plus numerous adjacent osteolytic lesions. Serum immunoelectrophoresis was normal, bone marrow had 0.5% of monoclonal plasmocytes, but D9's biopsy found a plasmacytoma. Despite bone marrow aspiration results, skeleton osteolytic lesions made multiple myeloma (MM) a more plausible diagnosis, later confirmed by the biopsy. The absence of classical MM findings, alongside a medullary compression syndrome, suggested an oligosecretory MM, which was proved by an altered FLC essay. This delayed diagnosis, with multiple diagnostic misguiding leads, also presents rare IgA and lambda chains production and normal levels of uninvolved immunoglobulins. Oligosecretory MM can lead to an inaccurate and delayed diagnosis, with devastating consequences to patient's morbidity and mortality. Therefore, FLC essay is essential in early assessment of potential MM patients.


Assuntos
Mieloma Múltiplo , Neoplasias de Plasmócitos , Osteólise , Plasmocitoma , Humanos , Imunoglobulinas , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/diagnóstico , Plasmocitoma/diagnóstico
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