Extramedullary plasmacytoma of median and sural nerve

Abstract

Localized plasmacytoma is a clonal plasma cell proliferation, immunophenotypically and cytologically identical to multiple myeloma (MM). The unique difference is an osseous or extraosseous growth pattern manifestation in the absence of disseminated bone marrow involvement. World Health Organization recognizes 2 types of localized plasmacytoma: solitary osseous plasmacytoma (SOP) and extramedullary plasmacytoma (EMP). SOP is a localized bone plasma cell neoplasm and it is histologically identical to MM. The diagnosis of SOP is appropriate in presence of negative skeletal survey and no bone marrow involvement. SOP has a strong tendency to progress into multiple myeloma and plasmacytoma is present at the time of initial diagnosis in 7–17 % of patients with MM [1]. EMP is a rare localized plasma cell neoplasm in tissues other than bone. 80–90 % of cases have been described in the aerodigestive tract [2]. Diagnostic studies include ultrasonography (US), magnetic resonance imaging (MRI) and electrophysiological tests. Therefore, histopathological and immunochemical analyses are essential to confirm the diagnosis of EMP. There is no consensus for the treatment. EMP is highly radiosensitive but surgery can be considered for easily resecable lesions such as localized type of EMP. For recurrence and disseminated infiltration, adjuvant chemotherapy may be considered after radiotherapy or surgery.

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