Skeletal trauma preceding the development of plasma cell dyscrasia: eight case reports and review of the literature

Plasma cell dyscrasias are clonal proliferations and accumulations of plasma cells. The etiology of monoclonal neoplasms still remains elusive. A direct correlation between a history of trauma and the development of plasma cell dyscrasias has not been established. Two recent case reports have described plasmacytomas that were diagnosed in patients who suffered injury at the site of plasma cell neoplasms. We report a series of eight patients who stated a history of trauma to the site where plasma cell neoplasms were later diagnosed. The duration from the date of injury to diagnosis ranged from 2 mo to 20 yr. The M:F ratio was 6:2. The median age was 52 (28-75). Multiple myeloma was confirmed in six patients and plasmacytoma without systemic disease in the other two patients. All eight patients had a kappa monoclonal plasma cell population, and all but one had a detectable peripheral kappa light chain. All patients presented with persistent discomfort at the site where they had experienced trauma. Even though this article does not establish a relationship between trauma, and the development of plasma cell dyscrasia, persistent discomfort at a previous trauma site warrants a complete evaluation and consideration for possible plasma cell dyscrasias.