Extramedullary Plasmacytoma Over the scar from Long-lasting Past Surgery as Presenting Feature of Multiple Myeloma

Author(s): David F. Moreno, Xavier Setoain, Joan Bladé, Laura Rosiñol

Plasmacytomas can have different clinical presentations. They can be observed as a single tumor mass without bone marrow involvement (solitary plasmacytoma) or in the context over multiple myeloma. In rare instances plasmacytomas are triggered by invasive surgical procedures. These different types of plasmacytomas can be found in the same patient which suggests a special biology of the malignant plasma cell that facilitates the spread outside the bone marrow. Here, we report the unique case of a 37-year-old man with solitary bone plasmacytoma with soft-tissue involvement who progressed to multiple myeloma with a huge mass at the scar of inguinal hernia surgery performed 10 years before. Throughout the course of the disease, he developed extensive multiple paraskeletal and extramedullary plasmacytomas at different locations.