To the Editor

We read with great interest the article by Yalcin and colleagues titled ‘A rare solitary plasmacytoma bone tumour in the hand mimicking an enchondroma’.1 The authors presented a well-documented case of solitary plasmacytoma of bone (SPB) in the metacarpal—an exceptionally rare presentation. The report underscores the importance of histopathological evaluation even in lesions with benign-appearing radiographic features. However, several aspects merit further consideration.

First, while the clinical and operative details were clearly presented, the diagnostic pathway could have been strengthened by using advanced imaging modalities such as MRI or CT-guided biopsy to differentiate SPB from enchondroma preoperatively. Evidence shows that image-guided biopsy improves diagnostic accuracy in musculoskeletal lesions while minimising fracture risk.2

Second, the one-year follow-up period, though encouraging, may be too short to assess disease progression. Transformation to multiple myeloma often occurs within two to three years despite initial local control.3 Including longer surveillance data or a detailed follow-up plan would improve the clinical value of the report.

Third, the finding of Epstein-Barr virus (EBV) positivity is particularly intriguing, as EBV has been linked to plasma cell neoplasms in select populations.4 Expanding on this virological association could offer novel insights into disease pathogenesis.

Lastly, given the extreme rarity of SPB in the hand, comparison with previously published cases5 in a summary table could have provided a broader context for clinicians.

In conclusion, Yalcin and colleagues have contributed an insightful case that reinforces the necessity of histopathological confirmation and multidisciplinary coordination in managing atypical hand tumours. Future reports could focus on extended follow-up and the role of viral markers in disease prognosis.

Sincerely,

Mohammad Idrees, Anfal Khan, Ameer Afzal Khan, Rahman Syed, Imran Khan

Conflict of interest

The authors have no conflicts of interest to disclose.