Yang Jin Seo, Cho Yong Jun, Kang Suk Hyung, Choi Hyuk Jai
Department of Neurosurgery, Spine Center, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, Korea.
J Korean Neurosurg Soc. 2013 Nov;54(5):426-30. doi: 10.3340/jkns.2013.54.5.426. Epub 2013 Nov 30.
The prognosis of solitary plasmacytoma varies greatly, with some patients recovering after surgical removal or local fractional radiation therapy, and others progressing to multiple myeloma years later. Primary detection of progression to multiple myeloma is important in the treatment of solitary plasmacytoma. There have been several analyses of the risk factors involved in the early progression to multiple myeloma. We describe one case of solitary plasmacytoma of the lumbar vertebra that was treated with surgical decompression with stabilization and additional radiotherapy. The patient had no factors associated with rapid progression to multiple myeloma such as age, size, immunologic results, pathological findings, and serum free light chain ratio at the time of diagnosis. However, his condition progressed to multiple myeloma less than two months after the initial diagnosis of solitary plasmacytoma. We suggest that surgeons should be vigilant in watching for rapid progression to multiple myeloma even in case that the patient with solitary plasmacytoma has no risk factors for rapid progression to multiple myeloma.
孤立性浆细胞瘤的预后差异很大，一些患者在手术切除或局部分次放射治疗后康复，而另一些患者在数年之后进展为多发性骨髓瘤。在孤立性浆细胞瘤的治疗中，早期发现进展为多发性骨髓瘤很重要。已经有多项关于早期进展为多发性骨髓瘤的危险因素分析。我们描述了一例腰椎孤立性浆细胞瘤患者，该患者接受了手术减压固定及额外放疗。该患者在诊断时没有与快速进展为多发性骨髓瘤相关的因素，如年龄、肿瘤大小、免疫结果、病理表现及血清游离轻链比值。然而，在孤立性浆细胞瘤初步诊断后不到两个月，他的病情就进展为多发性骨髓瘤。我们建议，即使孤立性浆细胞瘤患者没有快速进展为多发性骨髓瘤的危险因素，外科医生也应警惕其快速进展为多发性骨髓瘤的情况。
