Solitary Extramedullary Plasmacytoma of the Larynx Presenting with Stridor as a Primary Manifestation

Abstract

More than 90% of malignant tumors of the larynx are squamous cell carcinomas. Extramedullary plasmacytoma is a plasma cell tumour representing less than 1 % of all head and neck malignancies and involvement of the larynx is very rare. In the larynx the supraglottis is the primary site of involvement compared to the glottic and subglottic regions. We report a case of 54-yearold Indonesian female who presented at our clinic with stridor as primary manifestation secondary to solitary extramedullar plasmacytoma involving the glottis and subglottis of the larynx. The patient underwent microlaryngoscopy, biopsy and CO2 laser excision of the tumour with significant improvement of the airway and was referred for locoregional radiotherapy. We review the literature and discuss the management of this rare condition.

Clinical Features of Head and Neck Solitary Extramedullary Plasmacytoma in Taiwan

“…However, about 30%-50% of patients can progress to MM in a mean period ranging from 1.5 to 2.5 years (7). Statistical results vary from study to study (2)(3)(4)(5)(6)(7)(8)(9)(10), but the overall results appear to be compatible. Since 30%-50% of the patients progress to MM, it is critical to determine statistically significant risk factors and define practicable dose guidelines for radiation therapy.…”

“…Radiation therapy is currently the first line of treatment, with a local control rate reaching up to 90%. It has been reported that the 10-year disease-free and overall-survival rates range from 50% to 80%, and fewer than 10% of patients have local recurrence (2)(3)(4)(5)(6)(7)(8)(9)(10). However, about 30%-50% of patients can progress to MM in a mean period ranging from 1.5 to 2.5 years (7).…”

“…Due to its monoclonal nature, the neoplasm will produce either kappa or lambda light chain (ĸ-chain, λchain), which can be used to rule out other diagnoses such as undifferentiated carcinoma (2,4). The median age at diagnosis of SEP is between 55 and 60 years, and approximately two thirds of patients are male (6)(7)(8)(9). Current series about SEP are mainly reports from the West.…”