Rapid Disappearance of Testicular Plasmacytoma after Treatment with Lenalidomide plus Dexamethasone


We describe a rare case of testicular plasmacytoma first manifesting as a relapse. The patient was initially diagnosed with IgG-λ-type multiple myeloma and treated with melphalan and prednisolone plus bortezomib, achieving a complete remission. Four months later, his left scrotum began to swell and pathological investigation of a needle biopsy specimen revealed proliferation of plasma cells expressing IgG-λ, confirming myeloma recurrence. However, bone marrow aspiration samples showed no significant increase in myeloma cells and there was no skewed deviation of the K/λ ratio on flow-cytometric analysis. The extramedullary tumors disappeared completely soon after treatment with lenalidomide plus dexamethasone, and the patient was judged to be in very good partial remission based on negative M-protein results by serum immunoelectrophoresis. This is the first report, to our knowledge, describing complete disappearance of a testicular plasmacytoma after treatment with lenalidomide as the key-drug.

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M. Hagihara, M. Inoue, J. Hua, N. Iwaki, K. Yoshioka and T. Kobayashi, "Rapid Disappearance of Testicular Plasmacytoma after Treatment with Lenalidomide plus Dexamethasone," Open Journal of Pathology, Vol. 2 No. 4, 2012, pp. 155-158. doi: 10.4236/ojpathology.2012.24029.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] H. M. Turk, S. Komurcu, A. Ozet, O. Kuzhan and O. Gunhan, “An Unusual Presentation of Extramedullary Plasmacytoma in Testis and Review of the Literature,” Medical Oncology, Vol. 27, No. 4, 2010, pp. 1378-1380.
[2] H. S. Levin and F. K. Mostofi, “Symptomatic Plasmacytoma of the Testis,” Cancer, Vol. 25, No. 5, 1970, pp. 1193-1203.
[3] G. Chica, D. E. Johnson and A. G. Ayala, “Plasmacytoma of Testis Presenting as Primary Testicular Tumor,” Urology, Vol. 11, No. 1, 1978, pp. 90-92.
[4] N. F. Gowing, “Malignant Lymphoma of the Testis,” British Journal of Urology, Vol. 36, 1964, pp. 85-94.
[5] D. W. Hayes, W. A. Bennett and F. J. Heck, “Extramedullary Lesions in Multiple Myeloma: Review of Literature and Pathologic Studies,” AMA Archives of Pathology, Vol. 53, No. 3, 1952, pp. 262-272.
[6] G. Anghel, N. Petti, D. Remotti, C. Ruscio, F. Blandino and I. Majolino, “Testicular Plasmacytoma: Report of a Case and Review of the Literature,” American Journal of Hematology, Vol. 71, No. 2, 2002, pp. 98-104.
[7] A. M. Avitable, T. S. Gansler, J. E. Tomaszewski, P. Hanno and M. I. Goldwein, “Testicular Plasmacytoma,” Urology, Vol. 34, No. 1, 1989, pp. 51-54.
[8] P. I. Oppenheim, S. Cohen and K. H. Anders, “Testicular Plasmacytoma. A Case Report with Immunohistochemical Studies and Literature Review,” Archives of Pathology & Laboratory Medicine, Vol. 115, No. 6, 1991, pp. 629-632.
[9] M. Castagna, P. Gaeta, M. Cecchi, G. L. Pagni and R. Pingitore, “Bilateral Synchronous Testicular Involvement in Multiple Myeloma. Case Report and Review of the Literature,” Tumori, Vol. 83, No. 4, 1997, pp. 768-771.
[10] J. A. Ferry, R. H. Young and R. E. Scully, “Testicular and Epididymal Plasmacytoma: A Report of 7 Cases, Including Three That Were the Initial Manifestation of Plasma Cell Myeloma,” The American Journal of Surgical Pathology, Vol. 21, No. 5, 1997, pp. 590-598.
[11] H. Ulrich, “Multiple Myeloma,” Archives of Internal Medicine, Vol. 64, No. 5, 1939, pp. 994-1016.
[12] S. D. Fossa, M. Cvancarova, L. Chen, A. L. Allan, J. Oldenburg, D. R. Peterson and L. B. Travis, “Adverse Prognostic Factors for Testicular Cancer-Specific Survival: A Population-Based Study of 27,948 Patients,” Journal of Clinical Oncology, Vol. 26, No. 6, 2011, pp. 963-970.
[13] N. A. Mayr, B. C. Wen, D. H. Hussey, C. P. Burns, J. J. Staples, J. F. Doornbos and A. P. Vigliotti, “The Role of Radiation Therapy in the Treatment of Solitary Plasmacytomas,” Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology, Vol. 17, No. 4, 1990, pp. 293-303.
[14] M. Alvarez-Mugica, A. J. Monzon, V. B. Vazquez, C. A. Andrea, J. M. F. Gomez, R. C. G. Alvarez and F. J. R. Sejas, “Secondary Testicular Plasmocytoma,” Archivos Espanoles de Urologia, Vol. 60, No. 1, 2007, pp. 99-102.
[15] M. T. Krauth, A. Bankier, P. Valent, P. Kalhs and J. Drach, “Sustained Remission Including Marked Regression of a Paravertebral Plasmacytoma in a Patient with Heavily Pretreated, Relapsed Multiple Myeloma after Treatment with Bortezomib,” Leukemia Research, Vol. 29, No. 12, 2005, pp. 1473-1477.
[16] R. Laura, M. T. Cibeira, C. Uriburu, S. Yantorno, O. Salamero, J. Blade and E. Montserrat, “Bortezomib: An Effective Agent in Extramedullary Disease in Multiple Myeloma,” European Journal of Haematology, Vol. 76, No. 5, 2006, pp. 405-408.
[17] G. Damaj, M. Mohty, N. Vey, E. Dincan, R. Bouabdallah, C. Faucher, A. M. Stoppa and J. A. Gastaut, “Features of Extramedullary and Extraosseous Multiple Myeloma: A Report of 19 Patients from a Single Center,” European Journal of Haematology, Vol. 73, No. 6, 2004, pp. 402-406.
[18] M. Dimopoulos, A. Spencer, M. Attal, H. M. Prince, J. L. Harousseau, A. Dmoszynska, J. San Miguel, A. Hellmann, T. Facon, R. Foa, A. Corso, Z. Masliak, M. Olesnyckyj, Z. Yu, J. Patin, J. B. Zeldis and R. D. Knight, “Lenalidomide plus Dexamethasone for Relapsed or Refractory Multiple Myeloma,” The New England Journal of Medicine, Vol. 357, No. 21, 2007, pp. 2123-2132.
[19] M. A. Dimopoulos, E. Kastritis, D. Christoulas, M. Migkou, M. Gavriatopoulou, M. Gkotzamanidou, M. Iakovaki, C. Matsouka, D. Mparmparoussi, M. Roussou, E. Efstathiou and E. Terpos, “Treatment of Patients with Relapsed/Refractory Multiple Myeloma with Lenalidomide And Dexamethasone with or without Bortezomib: Prospective Evaluation of the Impact of Cytogenetic Abnormalities and of Previous Therapies,” Leukemia: Official Journal of the Leukemia Society of America, Vol. 24, No. 10, 2010, pp. 1769-1778.
[20] E. Kneppers, H. M. Lokhorst, C. M. Eeltink, G. Huls, M. J. Kersten, J. Koedam, M. C. Minnema, M. H. van Oers, R. A. Raymakers, M. R. Schaafsma, E. Vellenga, P. W. Wijermans, S. Wittebol, P. Sonneveld and S. Zweegman, “Analysis of Efficacy and Prognostic Factors of Lenalidomide Treatment as Part of a Dutch Compassionate Use Program,” Clinical lymphoma, Myeloma & Leukemia, Vol. 10, No. 2, 2010, pp. 138-143.
[21] S. Rosenberg, N. Shapur, O. Gofrit and R. Or, “Plasmacytoma of the Testis in a Patient with Previous Multiple Myeloma: Is the Testis a Sanctuary Site?” Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, Vol. 28, No. 27, 2010, pp. e456-e458.
[22] J. M. Calvo-Villas, A. Alegre, C. Calle, M. T. Hernandez, R. Garcia-Sanchez and G. Ramirez, “Lenalidomide Is Effective for Extramedullary Disease in Relapsed or Refractory Multiple Myeloma,” European Journal of Haematology, Vol. 87, No. 3, 2011, pp. 281-284.
[23] T. Fukushima, T. Nakamura, H. Iwao and H. Umehara, “Rapid Response of Plasmacytomas to Lenalidomide plus Low-Dose Dexamethasone Therapy in a Patient with Relapsed Multiple Myeloma,” American Journal of Hematology, Vol. 86, No. 10, 2011, p. 893.
[24] S. Kumar, R. Fonseca, A. Dispenzieri, M. Q. Lacy, J. A. Lust, L. Wellik, T. E. Witzig, M. A. Gertz, R. A. Kyle, P. R. Greipp and S. V. Rajkumar, “Prognostic Value of Angiogenesis in Solitary Bone Plasmacytoma,” Blood, Vol. 101, No. 5, 2003, pp. 1715-1717.
[25] J. Adams, V. J. Palombella, E. A. Sausville, J. Johnson, A. Destree, D. D. Lazarus, J. Maas, C. S. Pien, S. Prakash and P. J. Ellott, “Proteasome Inhibitors: A Novel Class of Potent and Effective Antitumor Agents,” Cancer Research, Vol. 59, No. 11, 1999, pp. 2615-2622.
[26] A. Palumbo, F. Gay, P. Falco, C. Crippa, V. Montefusco, F. Patriarca, F. Rossini, S. Caltagirone, G. Benevolo, N. Pescosta, T. Guglielmelli, S. Bringhen, M. Offidani, N. Giuliani, M. T. Petrucci, P. Musto, A. M. Liberati, G. Rossi, P. Corradini and M. Boccadoro, “Bortezomib as Induction before Autologous Transplantation, Followed by Lenalidomide as Consolidation-Maintenance in Untreated Multiple Myeloma Patients,” Journal of Clinical Oncology, Vol. 28, No. 5, 2010, pp. 800-807.

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