Extramedullary plasmacytoma of the nasopharynx: A case report and review of the literature

Abstract

Plasmacytoma is an extremely rare and discrete solitary mass of neoplastic monoclonal plasma cells. Extramedullary plasmacytoma (EMP) tends to occur during the fifth and seventh decades of life and is rarely diagnosed in younger patients. Only four cases of EMP have been previously reported in relatively young patients. Here we report a 15-year-old patient presenting with long-term nasal obstruction, who was found to have EMP of the nasopharynx. The patient was treated with surgery followed by radiotherapy with a satisfactory outcome. To the best of our knowledge, this study describes the the youngest individual with nasopharyngeal EMP to be reported in the literature.

Outcomes of Patients With Nasopharyngeal Plasmacytoma: A Systematic Review

“…Multiple myeloma is the most common type, bone solitary plasmacytoma, and soft tissue EMP being considerably less common (Table 4). 30 Genetic factors, smoking, chronic antigenic stimulation such as osteomyelitis, radiation exposure, and occupational exposures have also been reported as possible etiologic agents in the literature. 32 Wiltshaw et al 23 reported that 80% of extramedullary plasmacytomas occur in the head and neck region, and 40% of them occur in the nasal cavity and paranasal sinus, 20% in the nasopharynx, and 18% in the oropharynx.…”

“…Chemotherapy is generally recommended for recurrent, advanced, or disseminated disease. 30 Nasopharyngeal extramedullary plasmacytoma has a good prognosis but also requires a long-term follow-up to detect any local recurrence or progression towards multiple myeloma. Stage III has metastatic spread.…”

“…Immunohistochemical techniques may indicate a monoclonal staining pattern for heavy chain class, light chain class tumor or both, CD 138 has been reported as a gold marker for plasma cell tumor. 30,32 Complete surgical resection (if possible) with postoperative radiotherapy is the treatment of choice for solitary EMP. In general, EMPs are considered radiosensitive, with a local control rate of 90-100%.…”

Freiburg Neuropathology Case Conference: A Patient with Chronic Nasal Obstruction

“…Bone erosion may be present but can as well be caused by other neoplasms. Lymphadenopathy or disseminated disease is uncommon, but otherwise, the differentiation from nasopharyngeal lymphoma or carcinoma is generally not possible [3,4].…”

Composite Nasopharyngeal plasmacytoma with nodal paraimmunoblastic variant of small lymphocytic lymphoma: A case report

“…It comprises 5-10% of all plasma cell neoplasms. The most common sites of involvement are in the head and neck, particularly the upper respiratory tract (including the nasal cavity and the nasopharynx, which by itself is a rare occurrence) (1). To date, the origin of this type of tumor in chronic nasopharyngitis has not been described.…”