Surgery combined with radiotherapy for the treatment of solitary plasmacytoma of the rib: a case report and review of th
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CASE REPORT
Open Access
Surgery combined with radiotherapy for the treatment of solitary plasmacytoma of the rib: a case report and review of the literature Rui Jia†, Lei Xue†, Huagang Liang, Kun Gao, Jian Li and Zhefeng Zhang*
Abstract Solitary plasmacytoma of the bone, especially of a single rib, is a rare disease. We present the case of a 44-year-old Han Chinese man who was diagnosed with a solitary plasmacytoma of the bone located in the right sixth rib. The patient presented with a 4-year history of continuous pain in the right chest area and moderate fever lasting 7 days. A chest roentgenogram showed a solitary expanding lesion in the right thorax, and chest computed tomography revealed an osteolytic tumor in the chest wall. The patient underwent complete en-bloc resection of the chest wall, including the ribs, muscle, and parietal pleura. Histologically, the resected mass was composed of abundant neoplastic plasma cells, and the diagnosis was confirmed to be a plasmacytoma of rib. The examination of marrow cells showed 9 % normal plasma cells among karyocytes without clonal disease. On postoperative day 14, the patient underwent thoracic radiotherapy with a total dose of 50 Gy. The patient remained asymptomatic during the 6-month follow-up period. Herein, we also review previous reports on solitary plasmacytomas of the rib. In summary, this report provides further insights for the diagnosis and effective treatment of this rare disease. Keywords: Plasmacytoma, Rib, Surgery, Radiotherapy
Background Solitary plasmacytoma of bone (SPB) is a rare localized neoplasm that accounts for only 5 % of malignant plasma cell tumors [1]. SPBs typically occur in the vertebrae or pelvic bones, with presentation in the rib being less common [2, 3]. SPBs are characterized by the presence of only one or two isolated bone lesions with no evidence of disease dissemination and are generally considered to be curable with surgical resection and radiotherapy [4]. In most cases, SPBs present as osteolytic lesions of the bone on chest X-ray [5]. Herein, we report a case of solitary plasmacytoma of the rib (SPR) with unique clinical features. Case report A 44-year-old man visited our clinic complaining of continuous pain in the right chest area for 4 years and moderate fever for 7 days. He had no history of trauma or tuberculosis. A chest roentgenogram (Fig. 1a) and chest * Correspondence: [email protected] † Equal contributors Department of Thoracic Surgery, The First Hospital of Qinhuangdao, 258 Wenhua Road, Qinhuangdao, Hebei 066000, China
computed tomography (CT) (Fig. 2a and b) revealed a 6.11 cm × 9.33 cm, oval opacity in the right side of the chest, which was highly suspected to be an intrathoracic tumor originating from the pleura or rib. Spiral CT three-dimensional reconstruction showed an osteolytic lesion in the right sixth rib (Fig. 2c and d), and abnormally increased uptake of radioisotope around the right sixth rib was observed in a bone scan (Fig. 1b). The radiologic features suggested a focal lytic lesion in the rig
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