Renal plasmacytoma is extremely rare, presenting diagnostic challenges due to its unusual location and non-specific or absent symptoms. To the best of our knowledge, only 24 cases of renal plasmacytoma have been reported in the literature. The present study reports a case of primary renal plasmacytoma in a 46-year-old female patient. Computed tomography (CT) revealed that the mass was located in the lower pole of the left kidney and metastasis was detected in an enlarged para-aortic lymph node. Following careful preparation, a partial nephrectomy was performed and the retroperitoneal lymph node was resected. A pathological examination revealed a renal parenchyma with lymph node involvement; this was confirmed by immunohistochemistry and nested polymerase chain reaction (PCR).

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Consequently, a diagnosis of a renal extramedullary plasmacytoma (EMP) was proposed. Following this unexpected diagnosis, various examinations were performed, but there was no evidence of systemic plasma cell disease. The patient refused further therapy, including external beam radiotherapy and chemotherapy. Abdominal CT was performed three months post-surgery and did not reveal any relapse. The patient remains disease-free at nine months post-surgery. The current study also presents a review of the literature. Although the general prognosis and outcome of EMP is good, a follow-up examination is recommended due to the possibility of relapse or progression to plasma cell neoplasm (PCN).

Introduction Extramedullary plasmacytoma (EMP) is a rare malignant neoplasm that develops due to uncontrolled plasma cell proliferation and monoclonal plasmacytic infiltration (). The majority of EMPs are detected in the head and neck (), and the occurrence of an EMP in the kidney is extremely rare. This study presents a case of renal EMP and reviews the existing literature concerning EMPs, as well as multiple myelomas (MMs). EMPs may present as the main symptom of MM, or develop during the course of MM or occasionally occur as solitary tumors.

To the best of our knowledge, there are only 24 cases of renal plasmacytoma reported previously (). We report the case of a patient with renal EMP, who may have been diagnosed and treated incorrectly. The study was approved by the Ethics Committee of Sun Yat-sen University Cancer Center, Guangzhou, China. Written informed consent was obtained from the patient.

Case report A mass in the left kidney was detected in a 46-year-old female patient who underwent ultrasonography as part of a routine physical checkup. Computed tomography (CT) revealed that the mass showed enhancement, was located in the lower pole of the left kidney and measured 38×30 mm. Furthermore, metastasis was detected in an enlarged (20 mm) para-aortic lymph node ().

The radiologist suspected a diagnosis of renal cell carcinoma and advised a partial nephrectomy. However, the pre-operative work-up revealed the following: white blood cell (WBC) count, 2.7×10 9/l; percentage of neutrophils (NE%), 61.8; red blood cell (RBC) count, 3.58×10 12/l; hemoglobin (HGB) level, 101.1 g/l; platelet (PLT) count, 187.6×10 9/l; and serum creatinine, calcium and phosphorus levels within normal ranges.

Histological examination showing diffuse infiltration of plasmacytoid cells, which were of different sizes and at various degrees of differentiation. Hematoxylin-eosin staining; magnification, ×400.

Following this unexpected diagnosis, a skeletal survey was performed to complete the tumor staging. The survey did not reveal any lytic bone lesions or evidence of active malignant disease elsewhere.

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In addition, the urinalysis was positive for Bence-Jones protein. Serum protein electrophoresis excluded MMs and there was no evidence of systemic plasma cell disease. All these observations were consistent with a diagnosis of an EMP involving the kidney. The patient refused further therapy, including external beam radiotherapy and chemotherapy.