Primary Solitary Extramedullary Plasmacytoma Of The Liver Mimicking Hepatocellular Carcinoma: Case Report

Hepatic primary solitary extramedullary plasmacytoma (EMP) is a rare disease with few cases reported in the literature. In this case study, the patient was a 73-years-old man who exhibited a solitary hepatic mass on ultrasonography in a routine body examination when he presented to the 1st Affiliated Hospital, School of Medicine, Zhejiang University (Hangzhou, China) without any discomfort. The mass was then confirmed by magnetic resonance imaging (MRI) and computed tomography (CT) which initially suggested hepatocellular carcinoma (HCC). The patient was treated with a liver resection. Histologically, the tumor consisted of a diffused infiltration of plasma cells with slight atypia. Immunohistochemistry revealed the expression of CD138 and a Kappa light chain. Postoperatively, further examinations including bone marrow biopsy, skeletal radiography, serum and urine protein immunoelectrophoresis disclosed no abnormalities. There was no proof of anemia, hypercalcemia, or renal insufficiency. He was ultimately diagnosed with primary solitary EMP of the liver. After 13 months of close follow-up, the patient remained healthy. The imaging manifestations (ultrasound, CT and MRI) of EMP were similar to HCC, and the patient underwent the operation without chemotherapy or radiotherapy. Thus, we concluded that surgery alone gave an excellent result in this case whose resectability was good.