Case Report: Extramedullary Plasmacytoma of the oropharynx

Introduction:

A Plasmacytoma is an immunproliferative disease of the plasma cells. It is a solitary mass of neoplastic monoclonal plasma cells, which is typically localized in the bone marrow. Approximately 4% of plasmocytomas are localized in the soft tissue and are called solitary extramedullary plasmocytomas (EP). The EP can be found in many parts of the body, while 80% presents in the upper respiratory tract.

Methods/Case:

A 72-year old man presented with a foreign body sensation in throat since a week. The clinical examination showed a mass of the pharyngopalatine arch, which measured about 1 cm. The sonography of the throat did not show any abnormalities. A panendoscopy with laser excision of the tumor was performed. Histologically the tumor was a plasmacytoma. The staging examinations (laboratory studies, whole body CT-scan, urinanalysis, bone marrow biopsy) showed no other manifestations of the plasmacytoma, so that a solitary extramedullary plasmacytoma of the pharyngopalatine arch was diagnosed. After R0 status we decided for watch and wait with regular follow ups (clinical examination, laboratory test, imagine).

Results/Conclusion:

The EP is a very rare tumor of the ENT area (1%). Because of its rare manifestation, there are no uniform guidelines for its treatment. Therefore an individual therapy concept must be applied for every patient. It can be treated with radiotherapy, surgery, or a combined approach. It seems that chemotherapy has no influence on the risk of a relapse. The risk of progression to multiple myeloma for an extramedullary plasmacytoma is 10 – 20% and for a bone plasmacytoma 50%. Regular follow-ups, including staging examinations are necessary.

Publication History

Publication Date:
23 April 2019 (online)