Keywords
extramedullary plasmacytoma
How to Cite
Abstract
Extramedullary disease is an uncommon manifestation of multiple myeloma (MM). It can present de-novo or develop as a result of disease progression or relapse. We present a rare case of extramedullary myeloma (EMM) of the urinary tract in a 65-year-old gentleman.
The incidence of EMM is ~13% of the MM population with a higher predilection for males in the fifth decade. The common sites for EMM were lymph nodes, skin, and soft tissue, however, involvement of the urinary tract is exceedingly rare. Despite the combination of chemotherapy, radiotherapy, the novel agents of immunomodulators, proteosome inhibitors, and consolidative autologous hematopoietic stem cell transplantation, the relapse rate is relatively high. In conclusion, the prognosis of patients with EMM is poor and currently, the optimal treatment strategy for this subset of patients is still debatable.
References
He JingSong, Yue XiaoYan, He DongHua, Zhao Yi, Yang Yang, Zheng GaoFeng, Zhang Enfan, Han XiaoYan, Wu WenJun, Yang Li, Chen Jing, Cai Zhen. Multiple Extramedullary-Bone Related and/or Extramedullary Extraosseous Are Independent Poor Prognostic Factors in Patients With Newly Diagnosed Multiple Myeloma. Frontiers in Oncology, VOLUME 11, YEAR 2021. URL=https://www.frontiersin.org/articles/10.3389/fonc.2021.668099. DOI=10.3389/fonc.2021.668099
Pioli, Peter D. (2019). Plasma Cells, the Next Generation: Beyond Antibody Secretion. Frontiers in Immunology, 10(), 2768–. doi:10.3389/fimmu.2019.02768
Bladé, J., Beksac, M., Caers, J. et al. Extramedullary disease in multiple myeloma: a systematic literature review. Blood Cancer J. 12, 45 (2022). https://doi.org/10.1038/s41408-022-00643-3
Cyrille Touzeau, Philippe Moreau; How I treat extramedullary myeloma. Blood 2016; 127 (8): 971–976. doi: https://doi.org/10.1182/blood-2015-07-635383
Fernández de Larrea C, Kyle RA, Durie BGM, et al. International Myeloma Working GroupPlasma cell leukemia: consensus statement on diagnostic requirements, response criteria and treatment recommendations by the International Myeloma Working Group., Leukemia, 2013, vol. 27 4(pg. 780-791)
J. Churg, A.J. Gordon. Multiple myeloma with unusual visceral involvement. Arch Pathol (1942), pp. 546-556
Varettoni, M.; Corso, A.; Pica, G.; Mangiacavalli, S.; Pascutto, C.; Lazzarino, M. (2010). Incidence, presenting features and outcome of extramedullary disease in multiple myeloma: a longitudinal study on 1003 consecutive patients. Annals of Oncology, 21(2), 325–330. doi:10.1093/annonc/mdp329
Sabina Sevcikova, Jiri Minarik, Martin Stork, Tomas Jelinek, Ludek Pour, Roman Hajek, Extramedullary disease in multiple myeloma – controversies and future directions, Blood Reviews, Volume 36, 2019, Pages 32-39, ISSN 0268-960X, https://doi.org/10.1016/j.blre.2019.04.002.
Su Wen, Zeng Liang, Zhao Dongsheng, Fu Ying, Tang Jin. Case Report: Plasmacytoma of External Urethral Meatus, Frontiers in Endocrinology, VOLUME=13, 2022, https://www.frontiersin.org/articles/10.3389/fendo.2022.783855,DOI=10.3389/fendo.2022.783855
Wen G, Wang W, Zhang Y, Niu S, Li Q, Li Y. Management of extramedullary plasmacytoma: Role of radiotherapy and prognostic factor analysis in 55 patients. Chin J Cancer Res. 2017 Oct;29(5):438-446. doi: 10.21147/j.issn.1000-9604.2017.05.08
Köse M, Buraniqi E, Akpinar TS, Kayacan SM, Tükek T. Relapse of multiple myeloma presenting as extramedullary plasmacytomas in multiple organs. Case Rep Hematol. 2015;2015:452305. doi: 10.1155/2015/452305.
Saadvik Raghuram, Bini Faizal, K.V. Sanjeevan, Malini Eapen, Indu R. Nair, Arun Philip, Keechilat Pavithran. Recurrent extramedullary plasmacytomas without multiple myeloma: A case report with review of the literature., Cancer Treatment and Research Communications, Volume 31, 2022, 100550, ISSN 2468-2942. https://doi.org/10.1016/j.ctarc.2022.100550. (https://www.sciencedirect.com/science/article/pii/S2468294222000417)
Qian Ying, Qian Zijun, Zhao Xiujie, Pan Wenjue, Wei Xinzheng, Meng Huimin, Yang Lin, Xiao Haowen. Successful Treatment of Relapsed/Refractory Extramedullary Multiple Myeloma With Anti-BCMA CAR-T Cell Therapy Followed by Haploidentical Hematopoietic Stem Cell Transplantation: A Case Report and a Review of the Contemporary Literature. Frontiers in Medicine,VOLUME 8,2021. DOI:10.3389/fmed.2021.649824
Pour, Ludek & Sevcikova, Sabina & Greslikova, Henrieta & Kupska, Renata & Majkova, Petra & Zahradova, Lenka & Sandecka, Viera & Adam, Zahrah & Krejci, Marta & Kuglik, Petr & Hajek, Roman. (2013). Soft-tissue extramedullary prognosis is significantly worse in comparison to bone-related extramedullary relapse. Haematologica. 99. 10.3324/haematol.2013.094409.
Hernández-Rivas, JÁ., Ríos-Tamayo, R., Encinas, C. et al. The changing landscape of relapsed and/or refractory multiple myeloma (MM): fundamentals and controversies. Biomark Res 10, 1 (2022). https://doi.org/10.1186/s40364-021-00344-2
Gagelmann N, Eikema DJ, Iacobelli S, Koster L, Nahi H, Stoppa AM, et al. Impact of extramedullary disease in patients with newly diagnosed multiple myeloma undergoing autologous stem cell transplantation: a study from the Chronic Malignancies Working Party of the EBMT. Haematologica. 2018;103:890–7.
J Li, KN Shen, WR Huang, et al. Autologous stem cell transplant can overcome poor prognosis in patients with multiple myeloma with extramedullary plasmacytoma. Leuk. Lymphoma, 55 (7) (2014), pp. 1687-169
Wu P, Davies FE, Boyd K, Thomas K, Dines S, Saso RM, et al.The impact of extramedullary disease at presentation in outcome of myeloma. Leuk Lymphoma 2009;50(2):230-5
Farinola MA, Lawler LP, Rosenthal D. Plasmacytoma with involvement of the urinary bladder. Report of a case diagnosed by urine cytology. Acta Cytol. 2003;47:787–791.
Igel TC, Engen DE, Banks PM, et al. Renal plasmacytoma: mayo clinic experience and review of the literature. Urology. 1991;37:385–389.
Lopez A, Mendez F, Puras-Baez A. Extramedullary plasmacytoma invading the bladder: case report and review of the literature. Urol Oncol. 2003;21:419–423.
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