Summary
A patient with an extramedullary plasmacytoma of the omentum and ovaries is described. In spite of the presence of a very high concentration of paraprotein (103.5 g/l IgG k), bone marrow involvement was not demonstrated either at presentation or during the course of the disease. After debulking surgery, chemotherapy (vincristine, prednisone, and cyclophosphamide) was initiated. Although this resulted in considerable improvement, the paraproteinemia persisted. After ten courses of chemotherapy there was recurrence of the tumor with involvement of the lymph nodes in the right axilla. Chemotherapy was changed to a CHOP regimen (cyclophosphamide, adriamycin, vincristine, and prednisone), followed by autologous bone marrow transplantation with the BEAM regimen (BCNU, etoposide, cytarabine, melphalan) as conditioning therapy. The patient was still in complete remission 1 year after transplantation. This case demonstrates that an extramedullary plasmacytoma may become manifest as extensive but localized disease with high levels of paraprotein, and that autologous bone marrow transplantation as a therapeutic modality can lead to prolonged complete remission of the disease.
Similar content being viewed by others
References
Akiyama H, Krigel RL (1988) Metastatic extramedullary plasmacytoma: a case report and review of the literature of a rare pseudocarcinoma. Am J Hematol 27:115–117
Armitage JO (1989) Bone marrow transplantation in the treatment of patients with lymphoma. Blood 73:1749–1758
Bataille R (1982) Localized plasmacytomas. Clin Hematol 11:113–122
Bergsagel DE (1989) Plasma cell myeloma. In: Williams WJ, Beutler E, Erslev J, Lichtman MA (eds) Hematology. McGraw-Hill, New York, pp 1114–1141
Corwin J, Lindberg RD (1979) Solitary plasmacytoma of bone vs extramedullary plasmacytoma and their relationship to multiple myeloma. Cancer 43:1007–1013
Dimopoulos MA, Barlogie B, Smith TL, Alexanian R (1991) High serum lactate dehydrogenase level as a marker for drug resistance and short survival in multiple myeloma. Ann Intern Med 115:931–935
Ennuyer A, Bataini P, Chavanne G, Helary J (1963) Plasmocytomes des voies aero-digestive superieures. A propos de 248 cas, dont 19 traités à la fondation Curie. Ann Radiol (Paris) 6:741–768
Gahrton G, Tura S, Ljungman P, Belanger C, Brandt L, Cavo M, Facon T, Granena A, Gore M, Gratwohl A, Löwenberg B, Nikoskelainen J, Reiffers JJ, Samson D, Verdonck L, Volin L (1991) Allogenic bone marrow transplantation in multiple myeloma. N Engl J Med 325:1267–1273
Greenberg P, Parker RG, Fu YS, Abemayor E (1987) The treatment of solitary plasmacytoma of bone and extramedullary plasmacytoma. Am J Clin Oncol 10:199–204
Greer JP, Pinson RD, Russel WG, Keith TA, Collins RD, Graber SE (1985) Malignant plasmacytic ascites. Cancer 56:2001–2004
Hayes DW, Bennet WA, Heck FJ (1952) Extramedullar lesions in multiple myeloma. Arch Pathol 53:262–272
Jagannath S, Barlogie B, Dicke K, Alexanian R, Zagars G, Cheson B, Lemaistre FC, Smallwood L, Pruitt K, Dixon DO (1990) Autologous bone marrow transplantation in multiple myeloma: identification of prognostic factors. Blood 76:1860–1866
Jandle JH (1987) (eds) Blood, textbook of hematology. Little, Brown, Boston, pp 827–829
Knowling MA, Harwood AR, Bergsagel DE (1983) Comparison of extramedullary plasmacytomas with solitary and multiple plasma cell tumors of bone. J Clin Oncol 1:255–262
Medini E, Rao Y, Levitt SH (1980) Solitary extramedullary plasmacytoma of the upper respiratory and digestive tracts. Cancer 45:1893–1896
Meis JM, Butler JJ, Osborne BM, Ordonez NG (1987) Solitary plasmacytomas of bone and extramedullary plasmacytomas. Cancer 59:1475–1485
Soesan M, Paccagnella A, Chiarion-Seleni V, Salvagno L, Fornasiero A, Sotti G, Zorat PL, Favaretto A, Fiorentino M (1992) Extramedullary plasmacytoma: clinical behaviour and response to treatment. Ann Oncol 51–57
Woodruff RK, Whittle JM, Malpas JS (1979) Solitary plasmacytoma. I. Extramedullary soft tissue plasmacytoma. Cancer 43:2340–2343
Wiltshaw E (1976) The natural history of extramedullary plasmacytoma and its relation to solitary myeloma of bone and myelomatosis. Medicine 55:217–238
Yang C, Motteram R, Sandeman TF (1982) Extramedullary plasmacytoma of the bladder. Cancer 50:146–149
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Velders, G.A., Fibbe, W., Kluin, P.M. et al. Autologous bone marrow transplantation for intra-abdominal extramedullary plasmacytoma. Ann Hematol 69, 261–264 (1994). https://doi.org/10.1007/BF01700281
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01700281