An unexpected situation in isolated nasopharyngeal mass differential diagnosis: Solitary extramedullary plasmacytoma

Abstract

Solitary plasmacytoma accounts for 3–5% of all plasma cell diseases. Our case is about 55 years old male patient, who presented with isolated nasopharyngeal mass. He was consulted to Ear, Nose and Throat Diseases clinic by the Internal Medicine clinic with the complaints of dyspnea and difficulty in swallowing. With an initial diagnosis of the nasopharyngeal tumor; endoscopic examination, magnetic resonance imaging (MR) and tomography show a mass starting from the nasopharynx and reaching the right nasal cavity. As a result of biopsy, CD20 (−), CD19 (−), CD138 (+), CD38 (+), kappa (+), lambda (−), cyclin D1 (−) stained kappa light chain clonal plasma cells were detected and he was referred to our hematology clinic. Systemic disease was excluded by positron emission tomography–computed tomography (PET/CT), biochemical examinations and bone marrow biopsy. Remission was achieved only with localized radiotherapy. Solitary plasmacytomas appear with different clinical findings depending on their location. The diagnosis can be made in case of pathological reveal of clonal plasma cell containing tumor, absence of any other lesions or multiple myeloma-related tissue organ damage, presence of no more than 10% monoclonal plasma cells in the bone marrow. Radiotherapy plays a major role for the treatment.

Keywords

• Plasmacytoma
• Plasma cell dyscrasia
• Radiotherapy