Rare Rib-Originating Solitary Plasmacytoma: Retrospective Analysis and Surgical Outcomes.

Abstract

Introduction: Solitary plasmacytomas are tumors characterized by a local increase of malignant plasma cells in soft tissue or bone and may occur anywhere without evidence of systemic disease. The aim was to focus on the main surgical techniques and outcomes for this rare chest wall tumor.

Methods: Patients with solitary plasmacytoma involving a rib, who were operated for diagnostic or treatment purposes between 2018 and 2023 were retrospectively reviewed.

Results: Of the six patients included, three were male and the median age was 55.6 (range: 32-74) ys. All patients had preoperative positron emission tomography-computed tomography. Two underwent Tru-cut biopsy before surgery, but only one was then diagnosed. Two patients underwent surgery for diagnosis and the remainder underwent resection and reconstruction. In one patient with both rib and sternum involvement, rib and partial sternum resection was performed and the defect was repaired with mesh. During the 24.1 mos average follow-up period, two patients died, both of whom had metastasis preoperatively. The median survival of all patients was 24.1 (range: 3-63) mos.

Conclusions: Solitary plasmacytoma is rarely seen among primary malign tumors of the chest wall. A multidisciplinary approach is important in these cases. Surgical treatment in solitary plasmacytoma has fewer local and systemic side effects compared to radiotherapy and chemotherapy. Therefore, the place of surgery in the treatment of solitary plasmacytoma should be revised. Our findings show that surgery should be considered as not only a palliative treatment, but also a curative one, in solitary plasmacytomas arising in the rib.