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Periureteric plasmacytomas

Case contributed by Michael P Hartung
Diagnosis certain

Presentation

Disease staging.

Patient Data

Gender: Male
ct

Small pericardial and pleural effusions. Nodularity of both adrenals. 

Soft tissue insulating about the right ureter throughout its course, resulting in moderate hydronephrosis and delayed nephrogram. 

Several small presacral nodules. 

Case Discussion

Restaging examination for multiple myeloma (originally diagnosed with flow-cytometry of a treated abdominal mass) with several atypical sites of disease outside of the bone marrow (extramedullary plasmacytomas) involving the adrenal glands, right periureteric region, and presacral space. These were all growing on this examination and thus safely presumed to represent active disease. Identifying all sites of disease on such examinations help to determine chemotherapy and potentially targeted radiation therapy. 

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