What is Cutaneous Plasmacytoma?
Cutaneous plasmacytoma is a rare condition that is known to affect the skin. It is the primary form of cancer, which means it occurs on the skin primarily. Cutaneous plasmacytoma can also occur as a complication of multiple myeloma or plasmacytoma in the blood and this type is classified as secondary.
Diagnosing cutaneous plasmacytoma is difficult and a variety of tests are used by doctors to detect it. The treatment may depend on the cause of the condition and its severity. If not treated cutaneous plasmacytoma can progress to multiple myeloma and cancer of blood plasma cells. The progression may take 2-3 years but multiple myeloma is more difficult to treat and has a higher death rate than plasmacytoma.(1, 2)
Different Types of Plasmacytoma
Plasmacytoma begins in the plasma cells of a person’s bone or soft tissue. It can also occur in the intermediate phase between monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma.
People with MGUS have M protein present in the blood, which is a major risk factor for plasmacytoma.
Types of plasmacytoma include:
Solitary Plasmacytoma Of Bone
This type of plasmacytoma has more chances to progress to multiple myeloma and can also prove to be fatal.
This is a soft tissue cancer that can occur at any site. It is less common than extramedullary plasmacytoma. Around 2-4% of extramedullary plasmacytoma have skin or cutaneous involvement.(4)
It is a rare form of plasmacytoma that occurs only when cancer affects the skin.
Difference Between Primary and Secondary Cutaneous Plasmacytoma
Primary cutaneous plasmacytoma or primary extramedullary plasmacytoma occurs when cancer first appears on the skin.
It is a very uncommon presentation and if a person has it, the doctor suspects plasmacytoma or myeloma of any other part of the body.
Secondary cutaneous plasmacytoma happens when either plasmacytoma or multiple myeloma spreads from the original site to the skin.
Who Can Get Plasmacytoma?
Anyone can get plasmacytoma, but it can be common in the following individuals:
- People of advanced age are more likely to suffer from plasmacytoma.
- Males are twice as likely as females to develop plasmacytoma.
- African Americans are more likely to experience many diseases at a higher rate because of systemic and health racism.
- Exposure to toxic chemicals and ionic radiations may increase the risk of plasmacytosis.
- Certain viruses may increase the risk of cancer. The Epstein-Barr Virus increases the risk of blood cancer including plasmacytoma.
Symptoms of Cutaneous Plasmacytoma
Those with primary plasmacytoma may develop lesions on the skin. A study done in 2021 found that a person with primary cutaneous plasmacytoma developed multiple nodules.(5) The nodules presented to be tender, firm, and red to violet in color. The skin lesion in 78 years old man showed the signs of crusting and erosion.
Secondary cutaneous plasmacytoma may develop from the plasmacytoma in the bone or multiple myeloma. This may cause bone pain or tenderness around the bones. The other symptoms include:
A person with cutaneous plasmacytoma may experience weight loss as well.
How is Cutaneous Plasmacytoma Diagnosed?
As plasmacytoma mimics many other illnesses, it is difficult diagnosing it. A complete medical history is taken by the doctor and a physical examination is done in which he looks for injuries or infections.
The tests are ordered, which include:
- Blood test to look for M proteins in the blood serum
- Urine test to look for M protein in the urine
- Imaging studies including MRI or CT scan to look for a single lesion
A biopsy is done in which a culture is done of the area that the doctor thinks to contain cancer. A pathologist looks for tumor or plasma cells in the samples
Treatment of Cutaneous Plasmacytoma
Treatment for cutaneous plasmacytoma depends on the health of the person and the progression of the condition. Some of the treatment choices include:
- Radiation Therapy: It is a treatment of choice and has a control rate of 80%.(1)
- Chemotherapy: It is used as an additional and adjuvant therapy alongside other treatment methods.
- Surgery may be done to remove a portion or whole of the tumor. It is done to diagnose the type of cancer or treat cancer.
- An autologous stem cell transplant is an option for people with multiple or high-risk lesions.
People with multiple myeloma having cutaneous involvement may have a less positive outlook.(4) The outcome of primary cutaneous plasmacytoma depends on the number of skin lesions present and the condition of the person with it.(6)