Plasmacytoma

التشخيص

Diagnosing plasmacytoma takes several tests. Your care team needs to confirm that the tumor is a plasmacytoma. The team also needs to find out whether cancerous plasma cells are in your bone marrow or whether there are other tumors in your body.

A biopsy is used to confirm plasmacytoma. During a biopsy, a healthcare professional removes a sample of tissue for testing in a lab. The sample is checked for cancerous plasma cells. A computerized tomography (CT) scan or magnetic resonance imaging (MRI) may be used to guide the biopsy.

Along with a biopsy, other tests look for cancerous plasma cells in your bone marrow and tumors in other parts of your body. The results help your care team tell the difference between plasmacytoma and multiple myeloma. This is important because the two conditions are treated differently.

The goal of testing is not only to confirm plasmacytoma. It is also to make sure there isn't evidence of multiple myeloma anywhere else in the body.

Tests may include:

• Blood tests. Blood tests can check your blood cell counts, calcium levels and how well your kidneys are working. Other blood tests look for proteins made by the cancerous plasma cells. These proteins are called monoclonal proteins (M proteins).
• Urine tests. Urine tests also can look for M proteins. You may need to collect your urine over 24 hours for testing.
• Bone marrow tests. Bone marrow biopsy and bone marrow aspiration are procedures to collect and examine bone marrow. The tests look for cancerous plasma cells in your bone marrow. These tests are done after the first biopsy that confirms the tumor is plasmacytoma. Results of these tests help your care team understand how widespread your condition may be.
• Imaging tests. Whole-body MRI or a PET scan combined with a CT scan, called PET-CT, can look for other tumors or changes in the bone marrow. Finding other areas of concern can mean that the condition is multiple myeloma rather than solitary plasmacytoma. Regular X-rays may not find all the changes that can show whether a person has multiple myeloma.

Bone marrow is the soft tissue inside some bones where blood cells are made. Sometimes, bone marrow testing finds a small number of cancerous plasma cells even when imaging shows only one tumor. When less than 10% of the cells in the bone marrow are cancerous plasma cells, the condition is called solitary plasmacytoma with minimal bone marrow involvement. This condition is different from a solitary plasmacytoma in which no cancerous plasma cells are found in the bone marrow.

Plasmacytoma stages

There is no standard staging system for plasmacytoma. Instead, the tests used for diagnosis help show whether there is one tumor. Or they may show evidence of a more widespread plasma cell cancer, such as multiple myeloma.

العلاج

Treatment for plasmacytoma usually aims to control the tumor or get rid of it. Most plasmacytomas are treated with radiation therapy. Surgery may be used sometimes. The type of treatment you have depends on whether the tumor starts in a bone or in soft tissue outside the bones.

Solitary plasmacytoma of bone

Radiation therapy is the main treatment for a tumor that starts in a bone, called solitary plasmacytoma of bone. Radiation therapy uses high-energy beams to kill cancer cells. Plasmacytomas are sensitive to radiation. This means radiation therapy can often control or get rid of the tumor in the area being treated.

Radiation is directed at the tumor and the area around it. The amount of radiation and the area treated depend on how big the tumor is and where it's located.

You may need surgery if the tumor has weakened a bone or is pressing on the spinal cord or nerves. Surgery can help stabilize the bone or relieve pressure. Surgery doesn't replace radiation therapy for treating this type of plasmacytoma.

Extramedullary plasmacytoma

Radiation therapy also is a main treatment for a tumor that starts in soft tissues outside the bones, called extramedullary plasmacytoma. The treatment is directed at the tumor and the area around it.

Surgery may be used for some people when the tumor can be taken out. Radiation therapy often is still part of treatment. In selected cases, such as some tumors in the upper or lower airway, surgery alone may be an option.

Medicines

Medicines that treat cancer throughout the body, called systemic therapy, aren't usually used to treat plasmacytoma. Researchers are studying whether adding medicines to radiation therapy may help some people with solitary plasmacytoma who have a higher risk of developing multiple myeloma.

If plasmacytoma becomes multiple myeloma, treatment changes. You may then need to take medicines that are used to treat multiple myeloma.

Follow-up care

Regular follow-up care is important after treatment. Plasmacytoma can return or become multiple myeloma, sometimes years after treatment. Follow-up may include blood and urine tests along with imaging tests to look for changes.

Follow-up visits happen at regular intervals based on your care team's recommendations. For example, you may have follow-up visits every three months for the first two years after your first treatment. Then you may go back every six months for the next three years, followed by yearly visits after that. Your care team watches for any complications from treatment or signs that your cancer has returned.

التأقلم والدعم

Being diagnosed with plasmacytoma can bring uncertainty, especially because this cancer may be treated successfully but still needs long-term follow-up. You may worry about treatment, test results, or the chance that plasmacytoma could come back or become multiple myeloma.

These steps may help you cope with plasmacytoma:

• Understand your diagnosis. Ask your care team what type of plasmacytoma you have, where the tumor is and whether any tests show cancerous plasma cells in your bone marrow.
• Ask about your follow-up plan. Find out how often you need to have blood tests, urine tests or imaging tests after treatment. Also ask which results might lead to more testing or treatment.
• Keep track of important information. Keeping copies of your biopsy, bone marrow, blood, urine and imaging test results may help you feel more prepared for follow-up visits or visits with new specialists.
• Prepare for treatment and recovery. If you need radiation therapy or surgery, ask what side effects to expect, how treatment could affect daily activities and when to call your care team.
• Get emotional support. Talk with a trusted friend, counselor, social worker or mental health professional if worry affects your sleep, mood or daily activities.
• Ask for help from others. Invite someone you trust to come with you to appointments, help keep track of information, or support you during treatment and follow-up.

الاستعداد لموعدك

If you have symptoms that could be caused by plasmacytoma, you may start by seeing your usual healthcare professional. You may then be referred to a doctor who specializes in blood conditions, called a hematologist, or a doctor who specializes in treating cancer, called an oncologist.

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do ahead of time. Also:

• Write down your symptoms. Make note of when they started and whether they have changed over time.
• Write down important health information. Gather details about any other health conditions you have.
• Make a list of medicines you take. Include prescription and nonprescription medicines, vitamins and supplements. Also write down the amount, called the dose, that you take.
• Bring a family member or friend, if possible. Someone who comes with you can help you remember what your healthcare professional tells you.
• Write down questions to ask. Put your most important questions first in case time runs short.

For plasmacytoma, questions you may want to ask include:

• What type of plasmacytoma do I have?
• Where is the tumor?
• What tests do I need?
• Have you found cancerous plasma cells in my bone marrow?
• Do my test results show any signs of multiple myeloma?
• What treatment do you recommend?
• Will I need radiation therapy?
• Will I need surgery?
• What side effects might treatment cause?
• What is the chance that treatment will get rid of the plasmacytoma?
• What is the chance that the plasmacytoma will return or become multiple myeloma?
• What follow-up tests will I need?
• How often will I need follow-up visits?
• What symptoms should I report right away or seek emergency care for?
• Should I see a doctor who specializes in plasma cell cancers?
• Are there brochures or other printed materials I can take with me? What websites do you recommend?

Don't hesitate to ask other questions you may have.

What to expect from your doctor

Your healthcare professional is likely to ask you questions. These may include:

• What symptoms do you have?
• When did your symptoms start?
• Have your symptoms changed over time?
• Where do you have pain?
• Have you noticed a lump or swelling?
• Have you had numbness, tingling or weakness?
• Have you had trouble walking?
• Have you had any broken bones?
• Do you have any other health conditions?
• What medicines, vitamins and supplements do you take?