Uterine Extramedullary Plasmacytoma as a Primary Manifestation of Multiple Myeloma

Abstract

The association between plasmacytomas and multiple myeloma (MM) is well-described, and in about one third of the cases of plasmacytoma the additional study will lead to the diagnosis of MM. The finding of plasmacytomas in the genital tract is extremely rare, with sparse cases described in the literature, and these cases pose a challenge regarding the optimal guidance and treatment. This paper describes a case of uterine extramedullary plasmacytoma in a 79-year-old woman with complaints of postmenopausal abnormal uterine bleeding. The complementary study led to the diagnosis of uterine plasmacytoma and, subsequently, of MM. Despite the unfavorable outcome of this case, we consider pertinent to report it because it constitutes a differential diagnosis to be taken into account in the approach of pelvic masses.

Resumo

A associação entre plasmocitomas e mieloma múltiplo (MM) encontra-se bem demonstrada, e em cerca de um terço dos casos de plasmocitoma o estudo adicional conduzirá ao diagnóstico de MM. O achado de plasmocitomas no trato genital é extremamente raro, havendo um número muito limitado de casos descritos na literatura, o que dificulta concluir sobre a melhor forma de orientação e tratamento destes casos. O presente trabalho descreve um caso de plasmocitoma extramedular uterino em mulher de 79 anos estudada por queixas de hemorragia uterina anômala pós-menopáusica. O estudo complementar levou ao diagnóstico de plasmocitoma uterino e, posteriormente, de MM. Apesar do desfecho desfavorável do caso, consideramos pertinente o seu relato por se tratar de um diagnóstico diferencial a levar em consideração na abordagem de massas pélvicas.

Keywords

plasmacytoma - multiple myeloma

Palavras-chave

plasmocitoma - mieloma múltiplo

• References

• 1 Schols SE, Tick LL. Recurrent extramedullary plasmacytoma in asymptomatic multiple myeloma: a case report. J Med Case Reports 2015; 9: 37
• 2 Ruiz Santiago F, Tello Moreno M, Martín Castro A, Guzmán Alvarez L, Navarrete González P. Soft tissue extramedullary plasmacytoma. Case Rep Med 2010; 2010: 307902
• 3 Fischer EG, Bocklage TJ, Rabinowitz I, Smith HO, Viswanatha DS. Primary plasmacytoma arising in an endocervical polyp with detection of neoplastic cells on papanicolaou test. A case report and review of the literature. Arch Pathol Lab Med 2003; 127 (01) e28-e31
• 4 Mondal SK, Chatterjee S, Mandal S, Bhattacharjee D. Primary extramedullary plasmacytoma of ovary: Report of a rare neoplasm. J Cancer Res Ther 2015; 11 (04) 923-924
• 5 Zhong YP, Zhang JJ, Huang XN. Multiple myeloma with rupture of ovarian plasmacytoma. Chin Med J (Engl) 2012; 125 (16) 2948-2950
• 6 Emery JD, Kennedy AW, Tubbs RR, Castellani WJ, Hussein MA. Plasmacytoma of the ovary: a case report and literature review. Gynecol Oncol 1999; 73 (01) 151-154
• 7 Shakuntala P, Praveen S, Shankaranand B, Rajshekar K, Umadevi K, Bafna U. A rare case of plasmacytoma of the ovary: a case report and literature review. Ecancermedicalscience 2013; 7: 288
• 8 Pinto JA, Sônego TB, Artico MS, Leal CFA, Bellotto S. Extramedullary plasmacytoma of the larynx. Int Arch Otorhinolaryngol 2012; 16 (03) 410-413
• 9 Kilciksiz S, Karakoyun-Celik O, Agaoglu FY, Haydaroglu A. A review for solitary plasmacytoma of bone and extramedullary plasmacytoma. Sci World J 2012; 2012: 895765
• 10 Ooi GC, Chim JC, Au WY, Khong PL. Radiologic manifestations of primary solitary extramedullary and multiple solitary plasmacytomas. AJR Am J Roentgenol 2006; 186 (03) 821-827
• 11 Guo SQ, Zhang L, Wang YF. , et al. Prognostic factors associated with solitary plasmacytoma. Onco Targets Ther 2013; 6: 1659-1666
• 12 Huang H, Bazerbachi F, Mesa H, Gupta P. Asymptomatic multiple myeloma presenting as a nodular hepatic lesion: a case report and review of the literature. Ochsner J 2015; 15 (04) 457-467
• 13 Park YM. Imaging findings of plasmacytoma of both breasts as a preceding manifestation of multiple myeloma. Case Rep Med 2016; 2016: 6595610
• 14 Huang CC, Liu MT, Pi CP, Chung CY. Primary plasmacytoma of the uterine cervix treated with three-dimensional conformal radiotherapy. Singapore Med J 2008; 49 (12) e361-e364
• 15 Bladé J, de Larrea CF, Rosiñol L. Extramedullary involvement in multiple myeloma. Haematologica 2012; 97 (11) 1618-1619
• 16 Johansen B, Ahlbom G, Ostergård B. Extramedullary solitary plasmocytoma at the uterine cervix as a cause of postcoital bleeding. Acta Obstet Gynecol Scand 1989; 68 (03) 279-280
• 17 Sun N, Wang L, Li W. A case of extramedullary solitary plasmacytoma arising at the uterine cervix. Eur J Gynaecol Oncol 2012; 33 (04) 423-424