Yao J, He X, Wang CY, Hao L, Tan LL, Shen CJ, Hou MX. Solitary plasmacytoma of the left rib misdiagnosed as angina pectoris: A case report . World J Clin Cases 2022; 10(20): 7037-7044 [PMID: 36051148 DOI: 10.12998/wjcc.v10.i20.7037]
Corresponding Author of This Article
Jian Yao, MD, Doctor, Department of Cardiothoracic Surgery, Second Affiliated Hospital of Shenyang Medical College, The Veterans General Hospital of Liaoning Province, No. 20 Beijiu Road, Heping District, Shenyang 110001, Liaoning Province, China. yaoyao5506@hotmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jian Yao, Xu He, Cheng-Yuan Wang, Chun-Jian Shen, Ming-Xiao Hou, Department of Cardiothoracic Surgery, Second Affiliated Hospital of Shenyang Medical College, The Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China
Li Hao, Department of Pathology, Second Affiliated Hospital of Shenyang Medical College, the Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China
Li-Li Tan, Department of Cardiology, Second Affiliated Hospital of Shenyang Medical College, the Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China
Author contributions: Yao J, He X and Wang CY performed the operation; Shen CJ, Tan LL provided guidance on preoperative diagnosis; Hao L completed the pathological analysis and diagnosis; Yao J and Hou MX wrote and reviewed the paper; all authors issued final approval for the version to be submitted.
Informed consent statement: The patient provided written informed consent to publish this case report and accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Yao, MD, Doctor, Department of Cardiothoracic Surgery, Second Affiliated Hospital of Shenyang Medical College, The Veterans General Hospital of Liaoning Province, No. 20 Beijiu Road, Heping District, Shenyang 110001, Liaoning Province, China. yaoyao5506@hotmail.com
Received: November 22, 2021 Peer-review started: November 22, 2021 First decision: December 10, 2021 Revised: December 24, 2021 Accepted: May 22, 2022 Article in press: May 22, 2021 Published online: July 16, 2022
Abstract
BACKGROUND
Solitary plasmacytoma in the left rib is rare and can cause chest discomfort such as chest pain and tightness, and its clinical manifestations are not typical, so it is often misdiagnosed. We report a case of left costal plasmacytoma misdiagnosed as angina pectoris. We also review the literature and provide suggestions as to how to avoid misdiagnosis.
CASE SUMMARY
A 77-year-old man with a history of intermittent chest tightness for 3 years presented with pain in the left chest for 1 wk and was admitted to hospital. The cardiologists initially diagnosed angina pectoris but the findings of coronary angiography were not consistent with the symptoms. Computed tomography showed that the left eighth rib mass was accompanied by bone destruction. The patient was transferred to our department for further treatment. Preoperative biopsy indicated that the lesion was possibly malignant, and elective surgery was performed to remove the lesion. The size of the tumor was about 4 cm. The tumor was spindle-shaped and protruded into the pleural cavity, without invading the lungs. Postoperative pathology confirmed that the left rib lesion was plasmacytoma. After 14 mo follow-up, the patient died of systemic metastasis.
CONCLUSION
Left rib solitary plasmacytoma is a rare disease confined to a specific rib and can cause local pain. Attention should be paid to the differential diagnosis of angina pectoris to avoid misdiagnosis.
Core Tip: In the diagnosis of rib solitary plasmacytoma (SP), attention should be paid to the following aspects: the patient has an unknown cause of rib fracture or there is a long-term chest pain; and the computed tomography of the rib shows that osteolysis of ribs coexists with soft tissue mass around the rib. Local surgical resection is the first choice for the treatment of rib SP. Postoperative radiotherapy should be performed to obtain a better curative effect, prolong patient survival and prevent tumor progression and recurrence. Attention should be paid to the differential diagnosis from angina pectoris to avoid misdiagnosis.
