Management of Plasmacytoma and its outcome in a low resource setting
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Abstract
Background: Plasmacytoma is a rare solitary malignancy of plasma cell disorder in which there is proliferation of monoclonal plasma cells in tissues without evidence of overt multiple myeloma. It represents 3-7% of myeloma disorder. It is very radiosensitive, but the impact of chemotherapy in its management remains debatable with controversial literature.
Case summary: We report a case of solitary bone plasmacytoma in a middle-aged man who presented with three months history of upper back pain and one month history of inability to walk. He had decompressive laminectomy surgery following magnetic resonance imaging of the spine that showed cord compression with signal intensity at D2-D3. Histology of the surgical specimen turned out to be plasmacytoma. The patient had only chemotherapy with full recovery of neurological deficit without radiotherapy.
Conclusion: Even though the gold standard for the management of plasmacytoma is surgical excision and radiotherapy, the role of novel chemotherapy agents like Lenalidomide in combination with Dexamethasone in low resource settings where Radiotherapy is not readily available cannot be over emphasized as seen in our patient who regained total neurological deficit with improved quality of life post-surgery and chemotherapy.
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