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Multiple Primary Cutaneous Plasmacytomas

Multiple Primary Cutaneous Plasmacytomas Abstract • Background.— Cutaneous plasmacytoma is an uncommon tumor and is mostly seen in the context of end-stage multiple myeloma. Only 20 cases of primary cutaneous plasmacytoma have been documented. A significant proportion of these patients went on to develop systemic disease with a poor prognosis. In a number of patients, however, the abnormal clone of plasma cells may arise in the skin and never progress to multiple myeloma involving the bone marrow. Observations.— We describe a patient who developed multiple primary cutaneous plasmacytomas after a possible insect bite reaction. The monoclonality of the tumor cells is demonstrated using immunohistochemical techniques. He has been treated vigorously with chemotherapy and local radiotherapy and remains well 3 years after diagnosis. Bone marrow has been harvested for use as an autologous bone marrow transplant in the event of systemic relapse. Conclusions.— Unlike previous reports of this rare entity, this case documents the monoclonality of tissue plasma cells with immunohistochemical techniques. As cutaneous plasmacytomas have been reported with an early significant mortality, unlike extramedullary plasmacytomas elsewhere, we have advocated combination chemotherapy and cryopreservation of uninvolved bone marrow for future autologous bone marrow transplantation should systemic myelomatosis develop in the patient.(Arch Dermatol. 1992;128:962-965) References 1. Wiltshaw E. The natural history of extramedullary plasmacytoma and its relation to solitary myeloma of bone and myelomatosis . Medicine. 1976;553:217-238.Crossref 2. Volk R. Lokales plasmazytom der haut . Wien Med Wochenschr. 1936;86:720-721. 3. Stout AP, Frerichs JB. Plasmacytoma of the inframammary region . J Mo Med Assoc. 1949;46:275-277. 4. Krutsay MP. Solitary plasmacytoma of the skin . Oncologica. 1959;12:227-231.Crossref 5. Stritzler C. Diagnosis: multiple myeloma treated with ACTH and corticosteroids for 2.5 years . Arch Dermatol. 1961;83:194-196. 6. Fayolle F. Les expressions cutanées de la maladie maligne à plasmacytes ou les plasmacytoses malignes dermotropes . Ann Derm Syphiligraphie. 1963;90:67. 7. Mikhail GR, Spindler AC, Kelly AP. Malignant plasmacytoma cutis . Arch Dermatol. 1970;101:59-62.Crossref 8. La Perriere RJ, Wolf JE, Gellin GA. Primary cutaneous plasmacytoma . Arch Dermatol. 1973;107:99-100.Crossref 9. Klein M, Grishman E. Single cutaneous plasmacytoma with crystalloid inclusions . Arch Dermatol. 1977;113:64-68.Crossref 10. Altchek DD, Kurtin SB. An unusual histopathologic response to an insect bite . Cutis. 1980;25:169-170. 11. Suster SM, Ronnen M, Huszar M, Pines A, Schibi-Brilliant G. Induction of cutaneous plasma cell tumor as a complication of adjuvant immunotherapy with methanol extraction residue of bacillus Calmette-Guerin . Oncology. 1987;44:279-282.Crossref 12. Canlas MS, Dillon ML, Loughrin JJ. Primary cutaneous plasmacytoma . Arch Dermatol. 1979;115:722-724.Crossref 13. Burke WA, Merritt CC, Briggaman RA. Disseminated extramedullary plasmacytomas . J Am Acad Dermatol. 1986;14:335-339.Crossref 14. Shah A, Klimo P, Worth A. Multiple myeloma first observed as multiple cutaneous plasmacytomas . Arch Dermatol. 1982;118:922-924.Crossref 15. Johnson WH, Taylor BG. Solitary extramedullary plasmacytoma of the skin . Cancer. 1970;26:65-68.Crossref 16. Stankler L, Davidson JF. Multiple extra-medullary plasmacytomas of the skin . Br J Dermatol. 1974;90:217-221.Crossref 17. Kois JM, Sexton FM, Lookingbill DP. Cutaneous manifestations of multiple Myeloma . Arch Dermatol. 1991;127:69-74.Crossref 18. Hedinger E. Zur Frage des plasmacytomas . Frankfurt Z Pathol. 1911;7:343-350. 19. Agarwal SC. Extramedullary plasmacytoma: report of a case . Arch Dermatol. 1956;74:679-801.Crossref 20. Gold JE, Schwam L, Castella A, Pike SB, Opfell R, Zalusky R. Malignant plasma cell tumours in human immunodeficiency virus-infected patients . Cancer. 1990;66:363-368.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Multiple Primary Cutaneous Plasmacytomas

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Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1992.01680170094014
Publisher site
See Article on Publisher Site

Abstract

Abstract • Background.— Cutaneous plasmacytoma is an uncommon tumor and is mostly seen in the context of end-stage multiple myeloma. Only 20 cases of primary cutaneous plasmacytoma have been documented. A significant proportion of these patients went on to develop systemic disease with a poor prognosis. In a number of patients, however, the abnormal clone of plasma cells may arise in the skin and never progress to multiple myeloma involving the bone marrow. Observations.— We describe a patient who developed multiple primary cutaneous plasmacytomas after a possible insect bite reaction. The monoclonality of the tumor cells is demonstrated using immunohistochemical techniques. He has been treated vigorously with chemotherapy and local radiotherapy and remains well 3 years after diagnosis. Bone marrow has been harvested for use as an autologous bone marrow transplant in the event of systemic relapse. Conclusions.— Unlike previous reports of this rare entity, this case documents the monoclonality of tissue plasma cells with immunohistochemical techniques. As cutaneous plasmacytomas have been reported with an early significant mortality, unlike extramedullary plasmacytomas elsewhere, we have advocated combination chemotherapy and cryopreservation of uninvolved bone marrow for future autologous bone marrow transplantation should systemic myelomatosis develop in the patient.(Arch Dermatol. 1992;128:962-965) References 1. Wiltshaw E. The natural history of extramedullary plasmacytoma and its relation to solitary myeloma of bone and myelomatosis . Medicine. 1976;553:217-238.Crossref 2. Volk R. Lokales plasmazytom der haut . Wien Med Wochenschr. 1936;86:720-721. 3. Stout AP, Frerichs JB. Plasmacytoma of the inframammary region . J Mo Med Assoc. 1949;46:275-277. 4. Krutsay MP. Solitary plasmacytoma of the skin . Oncologica. 1959;12:227-231.Crossref 5. Stritzler C. Diagnosis: multiple myeloma treated with ACTH and corticosteroids for 2.5 years . Arch Dermatol. 1961;83:194-196. 6. Fayolle F. Les expressions cutanées de la maladie maligne à plasmacytes ou les plasmacytoses malignes dermotropes . Ann Derm Syphiligraphie. 1963;90:67. 7. Mikhail GR, Spindler AC, Kelly AP. Malignant plasmacytoma cutis . Arch Dermatol. 1970;101:59-62.Crossref 8. La Perriere RJ, Wolf JE, Gellin GA. Primary cutaneous plasmacytoma . Arch Dermatol. 1973;107:99-100.Crossref 9. Klein M, Grishman E. Single cutaneous plasmacytoma with crystalloid inclusions . Arch Dermatol. 1977;113:64-68.Crossref 10. Altchek DD, Kurtin SB. An unusual histopathologic response to an insect bite . Cutis. 1980;25:169-170. 11. Suster SM, Ronnen M, Huszar M, Pines A, Schibi-Brilliant G. Induction of cutaneous plasma cell tumor as a complication of adjuvant immunotherapy with methanol extraction residue of bacillus Calmette-Guerin . Oncology. 1987;44:279-282.Crossref 12. Canlas MS, Dillon ML, Loughrin JJ. Primary cutaneous plasmacytoma . Arch Dermatol. 1979;115:722-724.Crossref 13. Burke WA, Merritt CC, Briggaman RA. Disseminated extramedullary plasmacytomas . J Am Acad Dermatol. 1986;14:335-339.Crossref 14. Shah A, Klimo P, Worth A. Multiple myeloma first observed as multiple cutaneous plasmacytomas . Arch Dermatol. 1982;118:922-924.Crossref 15. Johnson WH, Taylor BG. Solitary extramedullary plasmacytoma of the skin . Cancer. 1970;26:65-68.Crossref 16. Stankler L, Davidson JF. Multiple extra-medullary plasmacytomas of the skin . Br J Dermatol. 1974;90:217-221.Crossref 17. Kois JM, Sexton FM, Lookingbill DP. Cutaneous manifestations of multiple Myeloma . Arch Dermatol. 1991;127:69-74.Crossref 18. Hedinger E. Zur Frage des plasmacytomas . Frankfurt Z Pathol. 1911;7:343-350. 19. Agarwal SC. Extramedullary plasmacytoma: report of a case . Arch Dermatol. 1956;74:679-801.Crossref 20. Gold JE, Schwam L, Castella A, Pike SB, Opfell R, Zalusky R. Malignant plasma cell tumours in human immunodeficiency virus-infected patients . Cancer. 1990;66:363-368.Crossref

Journal

Archives of Dermatology – American Medical Association

Published: Jul 1, 1992

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