Dear Label_Name,

Greetings! I hope you are well.

I am writing on behalf of an international publishing house, Science and Education Publishing, USA (http://www.sciepub.com).

Science and Education Publishing (SciEP) is a multidisciplinary open access publisher of Journals covering the fields of Science, Technology and Medicine. All SciEP publications are subject to high-quality peer review, editorial and production processes and are freely available online.

Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

We have released issues of some journals on February 2013.
American Journal of Public Health Research
American Journal of Medical Sciences and Medicine
American Journal of Medical and Biological Research
American Journal of Pharmacological Sciences
American Journal of Clinical Medicine Research
American Journal of Nursing Research
American Journal of Cancer Prevention
American Journal of Medicine Studies
American Journal of Infectious Diseases and Microbiology
American Journal of Cardiovascular Disease Research
American Journal of Biomedical Research
American Journal of Mechanical Engineering
American Journal of Microbiological Research
Journal of Preventive Medicine
American Journal of Food and Nutrition
American Journal of Hypertension Research
American Journal of Sports Science and Medicine
Journal of Cancer Research and Treatment
American Journal of Zoological Research
Journal of Biomedical Engineering and Technology
American Journal of Microbiological Research
Biomedical Science and Engineering

We are pleased to announce that submissions are now being accepted for peer review for all the journals across all our subject areas in SciEP.

Please submit your manuscript via our online submission system:
http://www.sciepub.com/author/signin

To unsubscribe from our mailing list, please click on the following link: unsubscribe

I am looking forward to hearing from you.

Kind regards,

David Rain
Email:join@sciepub.com
Science and Education Publishing (http://www.sciepub.com)

Solitary Plasmacytoma in the Oral cavity: A Case Report

Mehrdad Payandeh, Masoud Sadeghi*, Edris Sadeghi, Jalil Hamidi

Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract: Background: The plasma cell neoplasms may present in soft tissue as extramedullary plasmacytomas, in bone as a solitary plasmacytoma of bone, or as part of the multifocal disseminated disease multiple myeloma. The aim of study is to report solitary plasmacytoma in the oral cavity in a male patient. Case Report: A 65-year-old male was presented to our Clinic with hypertension, high fever and loss of balance. He had nine months ago one localized lytic lesion in his thoracic vertebrae T5. The clinical reports showed multiple myeloma for him. After that, He received melphalan and thalidomide for two months. The patients referred to Clinic again with a new oral lesion. In his treatment follow-up and biopsy from his new oral lesion, pathologist reported plasmacytoma. He was treated with radiotherapy(5.000 cGy), than received maintenance consisted of thalidomide 50 mg (VAD). He died after three months from treatment with VAD. Conclusion: The SPB is as part of the multifocal disseminated disease MM. Also, radiotherapy (5.000 cGy) and VAD are not optimal treatments for SPB.

Keywords: oral cavity, plasmacytoma, radiotherapy

Received March 28, 2015; Revised July 08, 2015; Accepted July 09, 2015

Citation: Mehrdad Payandeh, Masoud Sadeghi, Edris Sadeghi, Jalil Hamidi, Solitary Plasmacytoma in the Oral cavity: A Case Report. American Journal of Cancer Prevention, 3 (4). 72-73. January 2015. doi:10.12691/ajcp-3-4-1

1. Introduction

Solitary plasmacytoma of bone (SPB) and extramedullary plasmacytomas (EMP) are rare plasma cell proliferative disorders. Their diagnosis is based on histologic confirmation of monoclonal plasma cell infiltration of a single disease site and on the exclusion of systemic myeloma. [1] Patients with SPB are more likely to progress to multiple myeloma(MM), which adversely affects their survival compared with those with EMP. [2] The SPB usually occur in the vertebra and skull and are more common than EMP that almost always arise in the head and neck and may spread to regional lymph nodes. [3] Prognosis is relatively good and is better for patients with EMP compared with those presenting with SPB. [3] Localized pain, swelling, a raised red lesion on the alveolar ridge are the most clinical signs for plasmacytoma. This disease includes patients with more than one lesion, for it is elevated levels of myeloma protein, and excludes patients whose disease progressed within 2 years or whose abnormal protein persisted after radiotherapy. Absence of anemia, hypercalcemia, or renal impairment attributable to myeloma low, if present, concentrations of serum or urine monoclonal protein preserved levels of uninvolved immunoglobulins. [4] The aim of study is to report solitary plasmacytoma in the oral cavity in a male patient.

2. Case Report

In April 2013, a 65-year-old male was presented to our Clinic with hypertension, high fever and loss of balance. He had nine months ago one localized lytic lesion in his thoracic vertebrae T5. The clinical reports showed MM for him. He was treated with velcade (bortezomib), thalidomide 100 mg plus dexamethasone for six months. After that, He received melphalan and thalidomide for two months. The patients referred to Clinic again with a new oral lesion (Figure 1). In his treatment follow-up and biopsy from his new oral lesion, pathologist reported plasmacytoma. Pathologist evaluated this case by morphological analysis and IHC and reported that CD45, CD38 and EMA were positive but CD20, CD10, CD5, CD3, CDD23, CD15, CD99, Cytokeratin were negative and also Ki67 was 30% positive in cells. He was treated with radiotherapy (5.000 cGy), than received maintenance consisted of vincristin/sadriamycin/dexamethazone (VAD). He died after three months from treatment with VAD.

3. Discussion

The plasma cell neoplasms may present in soft tissue as EMP, in bone as a SPB, or as part of the multifocal disseminated disease multiple myeloma (MM). These tumors are derived from bone marrow stem cells of B-Lymphocyte lineage, and are characterized by an expansion of a clone of immunoglobulin-secreting cells. [5] Plasmacytoma is a clinical finding that is difficult to diagnose. Only the anatomopathological exam, preferably accompanied by an immunohistochemical study, can confirm the diagnosis through positive plasma cells that express CD38 with concomitant cytoplasmic expression of kappa or lambda light chains and the majority of patients with extramedullary plasmacytoma are male (63%-86%) [6].

Figure 1. An image showing solitary plasmacytoma in the oral cavity

Although EMP can occur in any site, 80-90% of tumors develop in the head and neck area, especially in the aerodigestive tract. Approximately 80% of cases involve the paranasal sinuses, pharynx, nasal cavity, or gums and oral mucosa. [7] Based on the documented radiation sensitivity of plasma cell tumors, the accepted treatment for EMP is radiotherapy. When a lesion can be completely resected, surgery provides the same results as radiotherapy. Combined therapy (surgery and radiotherapy) is an accepted treatment depending on the respectability of the lesion. [8] Romero et al. [9] concluded that The most widely accepted treatment is chemotherapy with cyclophosphamide, melphalan, and steroid protocols. Radiotherapy may also be used since the tumor is radiosensitive (eradicable at a dose of 4.000 to 5.000 cGy). Another alternative is surgical resection. Dimopoulos et al. [2] reported with modern radiotherapy and with a total dose of at least 4000 cGy, the risk for local recurrence is less than 5%. There is no role for systemic chemotherapy in the management of these disorders. Approximately 30% of patients with SBP remain disease-free for several years; some of these patients may be cured. Mendenhall et al. [3] reported that the optimal treatment for SBP is moderate-dose radiotherapy (40-50Gy) and occasionally surgery. In our study, the patient is male and CD38 was positive for him. Also, our patients had solitary plasmacytoma after nine months from diagnosis of MM. The patients was treated with radiotherapy (5.000 cGy) and VAD for plasmacytoma, but he died after 3 months. Therefore, survival in our patients was short.

In summary, the patient died with picture of pancytopenia without response to last treatment regimen of VAD. In beginning of disease, response was good but in follow-up of therapy, the patient went to a deteriorated way that we did not know why! It seems that he must be selected for bone marrow transplant (BMT), but when referred to this policy, he was rejected by BMT group.

4. Conclusion

The SPB is as part of the multifocal disseminated disease MM. Also, radiotherapy (5.000 cGy) and VAD are not optimal treatments for SPB (the patient despite of classic therapy, didn’t have good response). The specialists should be careful in type of chemotherapy for MM.

References

[1]   | Dimopoulos MA, Hamilos G. Solitary bone plasmacytoma and extramedullary plasmacytoma. Curr Treat Options Oncol. 3(3):255-9.2002.
[2]   | Dagan R, Morris CG, Kirwan J, Mendenhall WM. Solitary plasmacytoma. Am J Clin Oncol. 32(6):612-7.2009.
[3]   | Mendenhall WM, Mendenhall CM, Mendenhall NP. Solitary plasmacytoma of bone and soft tissues. Am J Otolaryngol. 24(6):395-9.2003.
[4]   | Dimopoulos MA, Moulopoulos LA, Maniatis A, Alexanian R. Solitary plasmacytoma of bone and asymptomatic multiple myeloma. Blood. 96(6):2037-44.2000.
[5]   | Regezi JA, Sciubba JJ, Jordan RCK. Oral Pathology: Clinical Pathologic Correlations. 4th Edn. Philadelphia, W.B. Saunders. 2003.
[6]   | Barros TP, Savilha FM, Amantea DV, Campolongo GD, Neto LB, Alves N, et al. Plasmacytoma in the oral cavity: A case report. Int J Odontostomat. 5(2):115-118. 2011.
[7]   | Galieni P, Cavo M, Pulsoni A, Avvisati G, Bigazzi C, Neri S, et al. Clinical outcome of extramedullary plasmacytoma. Haematologica. Jan .85(1):47-51.2000.
[8]   | Hu K, Yahalom J. Radiotherapy in the management of plasma cell tumors. Oncology (Williston Park). Jan .14(1):101-8.2000.
[9]   | Romero IL, Campos FA, Damasceno RW, Vital Filho J, Bison SH. Plasmacytoma of the orbit involving lacrimal gland with secondary transformation into multiple myeloma: case report. Arq Bras Oftalmol. 72(2):236-8.2009.