How would you approach a resected solitary osseous plasmacytoma?
With a few exceptions, surgery is rarely pursued as a definitive modality in hematologic malignancies. I have never seen an orthopedic oncologist attempt an oncologic resection for a solitary plasmacytoma of bone, so my subsequent thoughts are theoretical. In the (very unusual) situation posed, if the disease was relatively small and confined to the bone, surgical margins were widely negative, and post-surgery imaging was satisfactory, I suppose I would observe and not pursue any further treatment such as radiotherapy. On the other hand, if the margins were compromised, or there was extraosseous extension into the soft tissues of the chest wall, or post-surgery imaging was concerning, I would probably pursue radiotherapy.
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