Abstract
Aims
Solitary plasmacytoma of bone is a locally aggressive lesion seen by sarcoma teams. Some patients progress to myeloma. Local therapy decisions can be complex. This study reviews the experience of this condition in a single centre with a view to informing future treatment.
Methods
This was a retrospective review of clinical records.
Results
Between 1999 and 2011, 5094 patients were discussed at the MDT. 29 had a diagnosis of myeloma and 16 a diagnosis of solitary plasmacytoma. There were 12 males; mean age 62 (range 34 to 84). Tumours presented in the shoulder girdle in 5, the pelvis in 4, the femur in 2 and other sites in 5 cases. Standard treatment was radiotherapy, with chemotherapy for poor response in one case. 3 patients underwent surgery; one for a humeral fracture and two for acetabular reconstruction. Other lesions responded to radiotherapy but often left a defect in bone.
There was one local recurrence. 5 patients progressed to myeloma at a mean of 31 months (range 4 to 48).
Conclusion
Solitary plasmacytoma of bone appears to be well controlled with radiotherapy although some patients progress to myeloma despite apparently good local control. The role of surgery is primarily to treat mechanical complications arising from large bone defects. There is no evidence for radical surgical excision of solitary plasmacytoma.
