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射波刀立体定向放射外科治疗外耳道髓外浆细胞瘤:病例报告

CyberKnife stereotactic radiosurgery for extramedullary plasmacytoma in the external auditory canal: illustrative case.

作者信息

Patil Surya, Shaghaghian Elaheh, Yuan Lorenzo, Shah Aaryan, Marianayagam Neelan J, Park David J, Soltys Scott G, Veeravagu Anand, Gibbs Iris C, Li Gordon, Chang Steven D

机构信息

1Neurosurgery Artificial Intelligence Lab, Stanford University School of Medicine, Stanford, California; and.

2Department of Neurosurgery, Stanford University School of Medicine, Stanford, California.

出版信息

J Neurosurg Case Lessons. 2024 May 6;7(19). doi: 10.3171/CASE2479.

Abstract

BACKGROUND

Plasmacytoma, a rare plasma cell disorder, often presents as a solitary or multiple tumors within the bone marrow or soft tissues, typically associated with multiple myeloma. Extramedullary plasmacytomas (EMPs), particularly those located in the external auditory canal (EAC), are exceedingly rare and pose significant treatment challenges given their location, anatomical complexity, and high risk of recurrence.

OBSERVATIONS

The authors report the case of a 72-year-old male with a history of multiple myeloma, presenting with recurrent left EAC plasmacytoma. After initial conventional radiotherapy for the lesion, a recurrence was documented in 7 years. The patient subsequently underwent stereotactic radiosurgery, which proved successful, leading to complete resolution of the lesion without any long-term adverse effects or radiation-related complications over a 45-month period.

LESSONS

This case is a unique instance of utilizing stereotactic radiosurgery for recurrent EMP in the EAC, highlighting its potential as an effective approach in managing complex plasmacytomas.

摘要

背景

浆细胞瘤是一种罕见的浆细胞疾病,常表现为骨髓或软组织内的孤立性或多发性肿瘤,通常与多发性骨髓瘤相关。髓外浆细胞瘤(EMPs),尤其是位于外耳道(EAC)的髓外浆细胞瘤极为罕见,鉴于其位置、解剖结构复杂以及复发风险高,带来了重大的治疗挑战。

观察结果

作者报告了一例72岁男性,有多发性骨髓瘤病史,出现复发性左外耳道浆细胞瘤。对该病变进行初始常规放疗后,7年后记录到复发。患者随后接受了立体定向放射外科治疗,结果证明是成功的,在45个月的时间里病变完全消退,没有任何长期不良反应或与放疗相关的并发症。

经验教训

该病例是利用立体定向放射外科治疗外耳道复发性髓外浆细胞瘤的独特实例,突出了其作为管理复杂浆细胞瘤的有效方法的潜力。

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