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[A solitary extramedullary plasmacytoma of the nasopharynx]
Insights
This case study details an extramedullary plasmacytoma diagnosis in a 72-year-old male presenting with epistaxis. Successful combined treatment led to a sustained four-year remission without recurrence or metastasis.
Area of Science:
- Oncology
- Pathology
- Immunology
Background:
- Extramedullary plasmacytomas are rare plasma cell tumors.
- Nasopharyngeal tumors can present with symptoms like epistaxis.
- Distinguishing extramedullary plasmacytoma from multiple myeloma is crucial for treatment.
Observation:
- A 72-year-old male presented with epistaxis and a nasopharyngeal tumor.
- Immunohistopathology confirmed a plasmacytoma with IgG and lambda light chain.
- Serum electrophoresis, skeletal surveys, bone marrow aspiration, and scintigraphy ruled out multiple myeloma.
Findings:
- The patient was diagnosed with an extramedullary plasmacytoma.
- A multimodal treatment approach including chemotherapy, radiotherapy, and surgery was employed.
- The patient achieved a complete remission lasting over four years post-surgery.
Implications:
- This case highlights the importance of thorough diagnostic workup for nasopharyngeal masses.
- Multimodal therapy can be highly effective for localized extramedullary plasmacytomas.
- Long-term surveillance is essential to monitor for recurrence or metastasis.
Abstract:
A 72-year-old male, complaining of epistaxis, was referred to our hospital where a physical exam revealed a tumorous mass in the nasopharynx. A subsequent immunohistopathological investigation found that the tumor mass was a plasmacytoma with IgG and a lambda chain. Electrophoresis of a serum sample revealed a normal value and there was no signs indicating a multiple myeloma on x-ray surveys of the skeleton, or from bone marrow aspiration or scintigraphy. Thus the diagnosis was an extramedullary plasmacytoma and the patient received a combined treatment of chemotherapy, radiotherapy, and surgery. Since surgery, the patient has had neither a recurrence or a metastasis of the tumor for four years and three months.