Solitary Bone Plasmacytoma.: Case Report

Abstract

Introduction: Approximately 5% of plasma cell neoplasms correspond to solitary bone plasmacytoma (POS) with an age of presentation after the 5th decade of life, so its appearance at an early age is very rare, this being the reason of the presentation of this case.

Clinical case: The case corresponds to a 19-year-old woman with a history of a pathological fracture of the right femur. The bone biopsy reported a Solitary Plasmacytoma with positive Plasma Cell Immunohistochemistry, positive Kappa, CD38 and positive CD138. The bone marrow biopsy was normal as well as the concentrations of the different types of immunoglobulin and beta 2 microgobulin. Normal serum calcium. Gamma protein electrophoresis was 0.98 g / dl (14.3%). The bone series reported the presence of an osteolytic lesion of approximately 8 cm at the proximal diaphysis of the right femur with a pathological fracture. The rest of the skeleton without injuries.

Evolution: The patient received 4 cycles of chemotherapy with the VISTA protocol (Bortezomib 1.8 mg, Cyclophosphamide 500 mg, Dexamethasone 20 mg, Doxopeg 15 mg), after the first cycle, she underwent surgery with Osteosynthesis with a dynamic compression system (DCS) and a right proximal femur filling. The patient finished her chemotherapy treatment in November 2015 and concomitantly received radiotherapy at a dose of 50 Gys, which ended in October of the same year.

Outcome: The patient has remained in controls with periods of pain at the hip level that have been managed with analgesia and with radiological controls without evidence of recurrence. Currently the patient is asymptomatic, receiving bisphosphonates for 24 months.

Conclusion: This case highlights the importance of searching for oncological pathology in a young woman with a pathological fracture