Extramedullary nasal plasmacytoma arising after polyp excision and the role of the inflammation in tumor development: A case report

Abstract

A correlation between inflammation and cancer has been identified in the case of nasal cancer, however a specific connection between nasal inflammation and extramedullary nasal plasmacytoma (ENP), to the best of our knowledge, has not yet been determined. The present case report describes a patient affected by ENP, in who the tumor arose in the same area, from which a nasal polyp was previously surgically removed, five months after the polyp excision. The patient underwent surgical endoscopic tumor asportation without being treated with radio-chemotherapy. ENP was totally removed via surgery and no signs of recurrence were identified by endoscopy or magnetic resonance imaging during the last checkup 1 year after tumor asportation. It was hypothesized that in this elderly patient, who was exposed to viral infections and pollution for several years, ENP may be correlated to the inflammatory process that occurred after surgery, and this likely contributed to a neoplastic mutation in B-cells.

Extramedullary plasmacytoma of the larynx manifesting as chronic hypertrophic laryngitis

“…It could be hypothesized that chronic inflammation, resulting from known chronic irritation in the patient's history (GERD, smoking, asbestos, HPV viral infection), had played a crucial role in the development of EMP. This theory could be supported by the observation by DiStadio et al [9] who described the development of EMP of the nasal cavity stimulated by chronic inflammation. It is evident that more data needs to be accumulated to prove any causal relationship between these two entities.…”

Nasal Mass in a Middle-aged Woman With Multiple Myeloma and Recurrent Fungal Sinusitis

“…4 These soft-tissue plasmacytomas have a variety of causes, including local growth from medullary plasmacytomas or hematogenous spread of multiple myeloma to lymph nodes, skin, or sites of previous surgical procedures. 4,5 This patient's history of repeated surgical debridement for fungal sinusitis likely contributed to the development of nasal plasmacytoma. Trauma, including surgical scars or catheter insertions, can…”

“…serve as niduses for plasmacytoma formation. 4,5 Aside from her surgical history, the chronic inflammation of her previous persistent fungal sinusitis also might have contributed to her presentation because inflammatory states have been suggested to promote plasmacytoma development in patients with multiple myeloma. 4 On imaging, medullary plasmacytomas may present as lytic lesions, whereas EMPs can present as aberrations in soft tissue.…”

Septal Nasal Extramedullary Plasmacytoma: A Rare Tumor in an Unusual Area

“…1 This tumor represents 5% to 10% of all plasma cell neoplasms 2 and is commonly located in the nasal cavity and/or in the nasopharynx. Extramedullary nasal plasmacytoma generally arises from soft tissues where immune cells are more diffused 3 ; ENP is generally found in the nasal cavity, 2 posterior to the turbinate 3 or in the nasopharynx, 1,2 while its presence in the nasal septum has been rarely described. 4 The aim of this article is to present a rare case of ENP arising from the nasal septum.…”