Testicular Plasmacytoma
Section Editor: Dharam M. Ramnani, MD
Virginia Urology, Richmond, VA, USA
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Introduction: Extramedullary plasmacytomas are collections of neoplastic plasma cells outside of bone marrow. Testicular plasmacytomas occurring as primary solitary lesions are exceedingly rare and make up less than 0.1% of all testicular tumors. They are more common as secondary tumors in patients with generalized multiple myeloma.
Some patients have bilateral involvement which may be either synchronous or metachronous. Testis may also be the site of relapse of a previously treated multiple myeloma. It has been proposed that the testis is a sanctuary site from chemotherapy due to a blood-testis barrier.
Autopsy studies on patients who have died of multiple myeloma have shown a 2% frequency of testicular involvement. However, in most cases, the involvement remains clinically silent.
This orchiectomy specimen is an example of solitary plasmacytoma of the testis. There was no history of multiple myeloma at the time of diagnosis. It is not known if he subsequently developed multiple myeloma. Grossly, this multinodular, soft, fleshy, yellow-white tumor replaces most of the testis and cannot be distinguished from a lymphoma or a seminoma grossly. The diagnosis was confirmed with morphology and immunohistochemical stains.
Some patients have bilateral involvement which may be either synchronous or metachronous. Testis may also be the site of relapse of a previously treated multiple myeloma. It has been proposed that the testis is a sanctuary site from chemotherapy due to a blood-testis barrier.
Autopsy studies on patients who have died of multiple myeloma have shown a 2% frequency of testicular involvement. However, in most cases, the involvement remains clinically silent.
This orchiectomy specimen is an example of solitary plasmacytoma of the testis. There was no history of multiple myeloma at the time of diagnosis. It is not known if he subsequently developed multiple myeloma. Grossly, this multinodular, soft, fleshy, yellow-white tumor replaces most of the testis and cannot be distinguished from a lymphoma or a seminoma grossly. The diagnosis was confirmed with morphology and immunohistochemical stains.