[P-33] Extramedullary plasmacytoma in bladder

Dita Irmaya, Sri Suryanti and Friska Mardianti

Anatomical Pathology Department Faculty of Medicine Universitas Padjadjaran / Dr Hasan Hasan Sadikin General Hospital Bandung Indonesia

Background: Plasmacytoma is a rare B-lymphocyte neoplastic disorder that usually presents as the generalised disease multiple myeloma. Less than 5% of the cases present as a solitary mass of monoclonal plasma cells in the bone or soft tissue. Although solitary extramedullary plasmocytoma (EMP) may arise in any organ. However, it rarely affects bladder.

Case Presentation: A 62-year-old male without a history of multiple myeloma presented with urinary frequency and nocturia. This patient was previously diagnosed as infiltrating urothelial carcinoma of the bladder. A year later, the bladder ultrasound revealed a bladder mass and a subsequent flexible cystoscopy only demonstrated an area of irregular urothelium. Histology of a further formal resection of this irregular area revealed carcinoma with population of atypical cells with enlarged nuclei, prominent nucleoli and varying quantities of cytoplasm showing plasma cell features. The immunohistochemistry was consistent with a plasmacytoma.

Discussion and Conclusion: EMP of the urinary bladder is a rare entity with only 21 cases reported in the literature. In this report, we describe a further case of EMP of the bladder associated with transitional cell carcinoma (TCC) of the urothelium. We also highlight the important of histopathological findings. EMPs are highly radiosensitive tumours and in the case of head and neck disease. The 10-year survival rate is 65% following radical radiotherapy. According to the paucity of reported cases of bladder EMP, the optimal treatment regime remains unclear. In keeping with other anatomical sites, current treatment is based to the assumed benefit of radical radiotherapy and prognosis appears to be better in those with no evidence of systemic disease.