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Solitary Myeloma

Summary

Solitary plasmacytoma is a large solitary focus of plasma cell proliferation.

This tumor has a median patient age of approximately 10 years younger than multiple myeloma.
Pain is the most common symptom. However, if the myeloma occurs in the spine, it will usually present with fast developing paraplegia and gibbous deformity due to the vertebral collapse.
Complete Information on this Tumor
Introduction and Definition: 

Solitary plasmacytoma is a large solitary focus of plasma cell proliferation. This tumor is extremely rare and is found in the proximal femur, vertebral bodies, and pelvis in order of descending frequency. Solitary plasmacytoma occurs 70% of the time as an osseous lesion, and the rest of the cases are non-osseous lesions usually found in the upper respiratory tract. Approximately 70% of the patients with solitary plasmacytoma develop multiple myeloma.

Incidence and Demographics: 
This tumor has a median patient age of approximately 10 years younger than multiple myeloma, and affects men more than women.
Symptoms and Presentation: 

Pain is the most common symptom. However, if the myeloma occurs in the spine, it will usually present with fast developing paraplegia and gibbous deformity due to the vertebral collapse.

X-Ray Appearance and Advanced Imaging Findings: 
Radiologically, solitary plasmacytoma appears identical to multiple myeloma.
Differential Diagnosis: 
Most authors agree on a strict diagnostic criteria for solitary plasmacytoma. There may be no other radiological identifiable lesions, and bone marrow at another site must have no abnormal plasma cells. There may be no serum abnormalities and no Bence-Jones proteins in the urine. Some authors believe that the diagnosis can only be made if no other lesion is found for a period greater than 1 year.
Preferred Biopsy Technique for this Tumor: 
Bone marrow biopsy
Histopathology findings: 
Microscopically, solitary plasmacytoma appears as well to poorly differentiated sheets of plasma cells. These cells produce the same osteoclast stimulating factors found in multiple myeloma.
Treatment Options for this Tumor: 
Treatment of solitary plasmacytoma includes radiation or en-bloc surgical resection. If abnormal serum or urine findings are present then the patient must be treated as if they have multiple myeloma with chemotherapy and bone marrow transplant 2.
Outcomes of Treatment and Prognosis: 
Patients with solitary plasmacytoma have a better prognosis than patients with multiple myeloma, but 70% of solitary plasmacytoma patients develop multiple myeloma, and usually die within 5 years.
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