Anal canal plasmacytoma—An uncommon presentation site

BackgroundExtramedullary plasmacytomas (EMP) are rare plasma cell tumors that arise outside the bone marrow. They are most often located in the head and neck region, but may also occur in the other locations. The lower gastrointestinal EMP represents less than 5% of all cases, and location in the anal canal is exceedingly rare.AimWe present an exceedingly rare case of anal canal plasmacytoma, aiming to achieve a better understanding of this rare entity.MethodsWe report a case of a 61-year-old man with a bulky mass in the anal canal. The lesion measured about 6[[ce:hsp sp="0.25"/]]cm and invaded in all layers of the anal canal wall. The biopsy was performed and revealed a round and plasmocitoid cell population with a solid growth pattern and necrosis. The tumoral cells have express CD79a and CD138 with lambda chains. There was no evidence of disease in other locations and these features were consistent with the diagnosis of an extra-osseous plasmacytoma. The patient was submitted to conformal radiotherapy 50.4[[ce:hsp sp="0.25"/]]Gy total dose, 1.8[[ce:hsp sp="0.25"/]]Gy per fraction. After 24 months, the patient is asymptomatic and the lesion has completely disappeared.ConclusionsEMP accounts for approximately 3% of plasma cell malignancies. The median age is about 60 years, and the majority of patients are male. The treatment of choice for extramedullary plasmacytoma is radiation therapy in a dosage of about 50[[ce:hsp sp="0.25"/]]Gy. Patients should be followed-up for life with repeated bone marrow aspiration and protein studies to detect the development of multiple myeloma

3D conformal hypofractionated radical radiotherapy in early glottic cancer

AimThe purpose of this study was to evaluate acute and late toxicity and the locoregional control in patients treated with hypofractionated radical radiotherapy 2.25[[ce:hsp sp="0.25"/]]Gy/fraction/day for early glottic carcinoma.Materials and methodsA retrospective analysis was performed of 27 patients, stage T1–T2 N0 glottic squamous cell carcinoma, that underwent radical RT from April 2008 to October 2011. The mean age was 64.6 years (range 36–81). Seventeen patients were staged T1a, 3 patients T1b and 7 patients T2. All patients were 3D planned and treated in a 6[[ce:hsp sp="0.25"/]]MV LINAC, 2.25[[ce:hsp sp="0.25"/]]Gy/fraction/5 days per week, to a total dose between 63[[ce:hsp sp="0.25"/]]Gy and 67.5[[ce:hsp sp="0.25"/]]Gy. Biological Effective Dose (BED (α/β[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]10)) ranged from 77.18[[ce:hsp sp="0.25"/]]Gy to 82.69[[ce:hsp sp="0.25"/]]Gy and EQD2 from 64.31[[ce:hsp sp="0.25"/]]Gy to 68.91[[ce:hsp sp="0.25"/]]Gy. Patients were evaluated in periodic follow-up. Toxicity was evaluated according to RTOG Toxicities Scales.ResultsWith a median follow-time of 24.7 months (range 3.6–44.2 months), no evidence of locoregional recurrence was observed. The treatment was well tolerated and no unscheduled interruptions in treatments for toxicity were documented, with the median overall treatment time of 41 days (range 38–48). Only grades 1 and 2 acute toxicity were observed and no evidence of severe late toxicity.ConclusionThe authors believe that this moderately hypofractionated scheme can provide a good locoregional control for T1–T2 glottic carcinomas with no increase of toxicity. As the limitation of this work is the reduced number of patients and the lack of long term follow-up, the authors hope to update this retrospective study in the future in order to improve the power of the results

Anal canal plasmacytoma : an uncommon presentation site

Copyright © 2010 Greater Poland Cancer Centre, Poland. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.Background: Extramedullary plasmacytomas (EMP) are rare plasma cell tumors that arise outside the bone marrow. They are most often located in the head and neck region, but may also occur in the other locations. The lower gastrointestinal EMP represents less than 5% of all cases, and location in the anal canal is exceedingly rare. Aim: We present an exceedingly rare case of anal canal plasmacytoma, aiming to achieve a better understanding of this rare entity. Methods: We report a case of a 61-year-old man with a bulky mass in the anal canal. The lesion measured about 6 cm and invaded in all layers of the anal canal wall. The biopsy was performed and revealed a round and plasmocitoid cell population with a solid growth pattern and necrosis. The tumoral cells have express CD79a and CD138 with lambda chains. There was no evidence of disease in other locations and these features were consistent with the diagnosis of an extra-osseous plasmacytoma. The patient was submitted to conformal radiotherapy 50.4 Gy total dose, 1.8 Gy per fraction. After 24 months, the patient is asymptomatic and the lesion has completely disappeared. Conclusions: EMP accounts for approximately 3% of plasma cell malignancies. The median age is about 60 years, and the majority of patients are male. The treatment of choice for extramedullary plasmacytoma is radiation therapy in a dosage of about 50 Gy. Patients should be followed-up for life with repeated bone marrow aspiration and protein studies to detect the development of multiple myeloma.info:eu-repo/semantics/publishedVersio

A Case of Post-Radiotherapy Gastritis: Radiation Does Not Explain Everything

Hemorrhagic gastritis is a possible late toxicity outcome after radical radiotherapy but it is nowadays a very rare condition and most likely depends on other clinical factors. We report the case of a 77-year-old woman with a symptomatic solitary extramedullary intra-abdominal plasmacytoma and multiple gastric comorbidities, treated with external beam radiotherapy. Despite the good response to radiotherapy, the patient experienced multiple gastric bleeding a few months later, with the need of multiple treatments for its control. In this paper we will discuss in detail all aspects related to the different causes of hemorrhagic gastritis