Combined modality therapy for naso-oropharyngeal solitary extramedullary plasmacytoma: case report
Keywords:Naso-oropharynx, Extramedullary plasmacytoma, Surgery, Radiotherapy
Most patients with plasma cell neoplasia have generalized disease at diagnosis. However, some patients have a solitary extramedullary plasmacytomas (SEPs). SEPs are rare, typically solitary tumors comprising approximately 3–5% all plasma cell neoplasms. Almost 90% arise in the head and neck region, especially in the nasal cavity, sinuses, oropharynx, salivary glands and larynx. Solitary extramedullary plasmacytoma (SEP) has a predilection for the male gender and occurs most frequently in patients 50 years and older. SEP often runs an indolent clinical course with a tendency for local recurrence, and progresses to plasma cell myeloma in about 15% of patients. In this paper, we have reported the case of SEP of the naso-oropharynx in 55 years old woman who was presented with a sense of the nasal obstruction. The resection was performed and a mature plasmacytoma was demonstrated histologically. However, ENT examination and positron emission tomography/computed tomography examination with 18-fluorodeoxyglucose (18-FDG PET/CT) have shown that the patient had residual naso-oropharyngeal disease after surgery. A negative bone marrow biopsy and 18-FDG PET/CT have confirmed that it was a solitary extramedullary plasmacytoma of the head and neck region. Following the surgery, intensity modulated radiotherapy (IMRT) was administered. No relapse or progression to the multiple myeloma was recorded during the 3.5 years of follow-up. This case report, which describes a rare tumor of the naso-oropharynx, is expected to improve the recognition and referral of this condition in medical practice.
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