Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.7037
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
Processing time: 224 Days and 22.7 Hours
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.
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 plasma
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.