Clinical Features

Solitary plasmacytoma of bone is uncommon and occurs in 3-5% of patients with plasma cell neoplasms. It occurs more commonly in men than in women. The median age at diagnosis is approximately 55 years, which is a decade younger than that for multiple myeloma.

The most common symptom initially is pain at the site of the skeletal lesion. Severe back pain or cord compression may be the presenting feature. Pathologic fractures or a soft tissue extension of a solitary plasma-cytoma, such as in a rib, may result in a palpable mass.

The axial skeleton is more commonly involved than is the appendicular skeleton.2 Thoracic vertebrae are more often involved than are lumbar, sacral, or cervical vertebrae. Involvement of the distal axial skeleton below the knees or elbows is extremely rare. The recommended laboratory tests for identifying this entity are listed in Table 84.1.

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