Plasmacytoma is a monoclonal neoplasm derived from progenitor B lymphocyte. Extra-medullary plasmacytoma is proliferation of malignant plasma cells involving the soft tissues with the absence of malignant plasma cells in the bone marrow and with normal gammaglobulin in serum, which is a rarely occurring variant of solitary plasmacytoma (3-4% of all solitary plasmacytoma). Seventy two years old man, suffered from right side nasal blockage for last 6 months. Nasal endoscopy revealed ipsilateral complete choanal occlusion by an endophytic mass having smooth surface arising from the lateral wall of the nasopharynx with an extension to the same side of oropharynx. On computed tomography of paranasal sinus an endophytic homogenous enhancing soft tissue shadow arising predominantly from right postero-lateral nasopharyngeal wall with an extension to oropharynx and without any surrounding bony erosion. The lesion was completely excised endoscopically. Histopathology as well as immunohistochemistry confirmed plasmacytoma. Extra medullary plasmacytoma was diagnosed as per International Myeloma Working Group (IMWG) criteria. Patient was treated with radiotherapy in a total dose of 50Gy in 25 cycles. Follow up at 5 and 10 months showed no evidence of recurrence or progression to multiple myeloma. A rare tumourextra medullary plasmacytoma of naso-oropharynx has very good prognosis. The radiotherapy remains mainstay of treatment in extra-medullary plasmacytoma. The complete endoscopic excision before radiotherapy improves outcome of treatment as in this case.
展开▼
