Otolaryngology: Open Access
Open Access

Abstract

Rationale: Extramedullary Plasmacytoma (EMP) is an uncommon malignant neoplasm arising outside the bone marrow without clinical evidence of multiple myeloma. EMPs represent less than 1% of all head and neck malignancies mostly occur in nose and paranasal sinuses area. Local lymph node affection occurs at 10-20%. Some cases may be converted to multiple myeloma. Distant metastasis occurs in 35%. We reviewed 18 case reports of nasal plasmacytoma and found that EMP of nasal cavity and sinus affects men more than women and nasal cavity to be the most common site followed by maxillary sinus. Bleeding and nasal obstruction were the most common symptoms of nasal cavity EMP while facial swelling was the most common presenting symptom of the sinus EMP. On Physical Exam: Reddish pink polypoid mass easily bleeding was the most common finding. Deep biopsies must be taken as the tumor is sub-mucosal and the mucosa may be thickened as the result of an inflammatory reaction and biopsy material should be sent for immunohistochemical assessment. Treatment: Controversial, most effective radiotherapy with surgery. Prognosis is better than multiple myeloma and regular long-term follow up is mandatory as recurrence and metastases may occur after long time. Case Report: A 38-year-old female with history of nasal obstruction and epistaxis for several months presented to ER complaining of active epistaxis. Physical examination revealed a fragile and hemorrhagic polypoid mass in the right nasal cavity. CT scan showed a soft tissue mass in the right nasal cavity with contrast enhancement. Histopathological examination results revealed atypical plasma cell infiltration. Treatment was complete mass resection with radiotherapy. A diagnosis of EMP was made with these findings.

Biography

Omar Ramadan is an ENT Registrar at Al Adan Hospital, Kuwait. He has obtained his MS in Otolaryngology from University of Damasacus in 2012. He has completed his ENT Resident from Almouassat University Hospital during 2005-2010.

Email: omarram982@gmail.com