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Untreated plasmacytoma of bone containing macroscopic intralesional fat and mimicking intraosseous lipoma: A case report and review of the literature.

08:00 EDT 13th March 2020 | BioPortfolio

Summary of "Untreated plasmacytoma of bone containing macroscopic intralesional fat and mimicking intraosseous lipoma: A case report and review of the literature."

Solitary plasmacytoma is a rare form of plasma cell neoplasm defined by local neoplastic accumulation of monoclonal plasma cells in the absence of systemic proliferative plasma cell disease. In this case report, a 65-year-old female with remote past medical history of papillary thyroid cancer presented with shoulder pain and radiographs showing an aggressive osteolytic lesion presumed to represent an osseous metastasis. The subsequent MRI and CT examinations demonstrated diffuse intralesional macroscopic fat without a nonlipogenic soft tissue component or focal, nodular mass-like enhancement. The presence of macroscopic fat in an untreated osseous lesion suggested a benign lesion with the favored diagnosis an intraosseous lipoma with non-displaced pathological fracture. Therefore, the decision was made to forego image-guided percutaneous biopsy and instead proceed directly to open surgical biopsy and partial distal claviculectomy. Pathology of the resected specimen showed focally dense infiltration of plasma cells within the marrow space and scant hematopoiesis compatible with a plasma cell neoplasm. To the best of our knowledge, this is first case report of solitary plasmacytoma of bone, or any untreated plasma cell neoplasm, containing macroscopic fat upon imaging. The decision to forego image-guided percutaneous biopsy had significant treatment implications as the primary therapy for patients with SPB is not surgical, but localized radiation therapy. Based on this case, solitary plasmacytoma of bone may be included as one of the rare fat containing malignant bone lesions and imaging guided percutaneous biopsy should be considered in symptomatic fat-containing bone lesions.

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Name: Clinical imaging
ISSN: 1873-4499
Pages: 18-23

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Medical and Biotech [MESH] Definitions

Any discrete, presumably solitary, mass of neoplastic PLASMA CELLS either in BONE MARROW or various extramedullary sites.

The administration of medication or fluid through a needle directly into the bone marrow. The technique is especially useful in the management of pediatric emergencies when intravenous access to the systemic circulation is difficult.

The eight bones of the wrist: SCAPHOID BONE; LUNATE BONE; TRIQUETRUM BONE; PISIFORM BONE; TRAPEZIUM BONE; TRAPEZOID BONE; CAPITATE BONE; and HAMATE BONE.

Agents that inhibit BONE RESORPTION and/or favor BONE MINERALIZATION and BONE REGENERATION. They are used to heal BONE FRACTURES and to treat METABOLIC BONE DISEASES.

A type of osseous tissue which makes up the inner part of bone. It has a spongy, honeycomb-like structure with struts or trabecula and contains the BONE MARROW. It has higher rate of BONE REMODELING turnover than CORTICAL BONE.

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