Alfar Rozan, Kamal Nazmi, Abdel Razeq Rashid, Omari Zaid, Bater Rayan, Sharaf Baha'
Internal Medicine Department, King Hussein Cancer Center, Amman, Jordan.
Pathology Department, Hematopathology Section, King Hussein Cancer Center, Amman, Jordan.
Onco Targets Ther. 2022 Nov 7;15:1347-1354. doi: 10.2147/OTT.S372534. eCollection 2022.
Primary isolated extra-medullary plasmacytoma (EMP) is a rare entity that most commonly involves the nasopharynx or upper respiratory tract. Only 10% of cases involve the gastrointestinal tract, mainly the small intestine and the stomach. Involvement of the colon is extremely rare with less than 40 reported cases worldwide.
We report a case of a 57-year-old man who was presented with a 3-week history of fresh bleeding from the rectum. Colonoscopy showed a polypoidal mass arising from the ascending colon; biopsy showed clonal plasmacytosis and a primary colonic solitary EMP diagnosis was made after exclusion of multiple myeloma (MM). Accordingly, the patient underwent a right hemicolectomy, followed by 6 cycles of bortezomib, cyclophosphamide, and dexamethasone (VCD). The patient continued to be disease-free 30 months after the completion of his chemotherapy.
To our knowledge, this is the first reported case of primary colonic plasmacytoma managed with surgical resection followed by an adjuvant bortezomib-based regimen with a durable response.
原发性孤立性髓外浆细胞瘤（EMP）是一种罕见的疾病，最常累及鼻咽部或上呼吸道。仅有10%的病例累及胃肠道，主要是小肠和胃。结肠受累极为罕见，全球报道病例少于40例。
我们报告一例57岁男性，有3周直肠新鲜出血病史。结肠镜检查显示升结肠有一息肉样肿物；活检显示克隆性浆细胞增多，排除多发性骨髓瘤（MM）后诊断为原发性结肠孤立性EMP。因此，患者接受了右半结肠切除术，随后进行了6个周期的硼替佐米、环磷酰胺和地塞米松（VCD）治疗。化疗结束30个月后，患者仍无疾病复发。
据我们所知，这是首例报道的经手术切除并采用基于硼替佐米的辅助方案治疗且疗效持久的原发性结肠浆细胞瘤病例。
