The Teaching Point

In patients with a history of multiple myeloma presenting with a palpable breast mass, breast plasmacytoma should be included in the differential diagnosis and further worked up with dedicated breast imaging (mammography, US, and MRI if needed). Generally, imaging will show round or oval well-circumscribed vascular masses, in which a biopsy should be considered to rule out primary breast malignancy and guide treatment.






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From the manuscript

Extramedullary Plasmacytoma of the breast in a patient with Multiple Myeloma

Free full text article: Extramedullary Plasmacytoma of the breast in a patient with Multiple Myeloma

Abstract
Extramedullary plasmacytoma of the breast is rare. It is important to recognize the imaging findings and include it as a differential consideration in multiple myeloma patients with a breast mass. A 74-year-old woman undergoing chemotherapy for relapsed multiple myeloma presented with a palpable mass in her right breast. A screening mammogram four months prior was unremarkable. She underwent a diagnostic right mammogram which showed two well-circumscribed hyperdense masses. An ultrasound of the right breast showed mixed echogenic masses with indistinct margins and increased vascularity. Ultrasound guided biopsy confirmed the presence of an extramedullary plasmacytoma. A follow-up whole body PET/CT demonstrated an FDG-avid right breast mass with extensive osseous metastases.






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