**Part 2**

**Multiple Myeloma Management: Issues and Considerations** 

174 Multiple Myeloma – An Overview

Wirk, B. (2011). Renal failure in multiple myeloma: a medical emergency. *Bone Marrow* 

Wisloff, F., Kvam, A.K., Hjorth, M., & Lenhoff, S. (2007). Serum calcium is an independent

(January 2007), pp. 29-34, Print ISSN: 0902-4441 Online ISSN: 1600-0609.

ISSN: 0732-183X Online ISSN: 1527-7755

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and clinical implications. *J Clin Oncol*, Vol.25, No.9, (March 2007), pp. 1121-28, Print

*Transplant*, Vol.46, No.6, (June 2011), pp. 771-83, Print ISSN: 0268-3369 Online ISSN:

predictor of quality of life in multiple myeloma. *Eur J Haematol*, Vol.78, No.1,

**9** 

*China* 

**Solitary Plasmacytoma of Bone** 

Solitary plasmacytoma (SP), histologically indistinguishable from multiple myeloma (MM), is a kind of malignant tumor characterized by the proliferation of monoclonal plasma cells. SP is an independent subtype of plasmacytoma, including extramedullary plasmacytoma and solitary plasmacytoma of bone (SPB) [1]. Most solitary plasmacytomas progress to MM, and are usually treated in the department of hematology. SPB may involve in any bone, however, it mainly occurs in the axial skeleton, especially in a vertebra. SPB has a high risk of progression to MM, and on magnetic resonance imaging (MRI) examination, at least 25% of patients with an apparent solitary lesion have evidence

In patients with solitary plasmacytoma of bone, the diagnosis can be made in the light of clinical and radiographic manifestations combined pathology. Thereafter, systemic treatment should be performed according to the status of the patients and the evidence of

Although definitive local radiotherapy is a choice for the treatment of SPB, no affirmative conclusion can be drawn due to the lack of randomized trials for this kind of disease. Surgical management is usually non-mandatory; however, patients may require decompression or

SPB is a primary malignant tumor, mainly affecting axial skeleton, especially the vertebra[2]. These tumors occur in the spine twice as often as other bony sites [7]. The male/female ratio of SPB is about 2 to 1 with a mean age of 55 years [2]. Solitary plasmacytoma is one of the most common malignant primary tumors in spine. Involvement of the base of the skull may present with cranial nerve palsies. The early symptoms of SPB are not typical. The most common presenting symptom is pain. If spine is involved, deformity, motor deficits, sensory deficits, n bowel and bladder dysfunction could be seen as well as pain as result of epidural spinal-cord compression and/or instability of the vertebra. Plain radiography shows expansile, irregular osteolytic lesions with or without vertebra instability [8-9]. CT or MRI can detect the lesions and describe the tumor extent at an earlier stage. Particularly, MRI scanning has an important reference value in description of residual tumor, local relapse

reconstruction if there are spinal cord compression and pathological fracture.

**1. Introduction** 

of disease elsewhere.

disease progression [2-6].

**2. Epidemiology and clinical features** 

Jianru Xiao, Wending Huang, Xinghai Yang and Honglin Teng *The Second Military Medical University* 
