Sagrario Maria Santos Seoane
Multiple solitary plasmacytomas is defined as the presence of more than one plasmacytoma (occurring concurrently or sequentially) in the absence of bone marrow evidence of multiple myeloma. Approximately 30 to 50 percent of patients with suspected solitary plasmacytoma of bone will have multiple asymptomatic lesions detected by PET/CT or MRI of the spine. Many clinicians advocate the use of local radiation directed at the symptomatic site with further treatment postponed until the development of symptoms. For others, the treatment is considered depending upon the number and location of involved sites. If a patient has two different concurrent plasmacytomas without involvement of the bone marrow, it would be treated with radiotherapy in both places, followed by observation as long as the radiation fields are limited. If the radiation fields are large and may interfere with the collection of stem cells or bone marrow reserve, a systemic therapy identical to that used for MM instead of radiation would be administered. If a patient has more than two concurrent lesions, a systemic therapy identical to that used for multiple myeloma would be administered, even if the bone marrow is normal. If the patient develops two or three apparently solitary lesions within a period of one to two years, subsequent therapy should be as if the patient has multiple myeloma. Keywords :
