J Rhinol.  2023 Nov;30(3):173-176. 10.18787/jr.2023.00032.

A Case of Extramedullary Plasmacytoma in Both Maxillary Sinuses

• Seo M
• Park JH
• Kim SD
• Choi KU
• Cho KS

• KMID: 2548196
• DOI: http://doi.org/10.18787/jr.2023.00032

Abstract

Plasmacytoma is a rare hematolymphoid malignancy. The three types of plasmacytoma, according to clinical features and morphological characteristics, include solitary bone plasmacytoma, extramedullary plasmacytoma (EMP), and multiple myeloma (MM). Although EMP of the head and neck region accounts for approximately 3% of all plasma cell tumors, the involvement of both paranasal sinuses is extremely rare. Herein, we describe a rare case of EMP involving both maxillary sinuses in a 73-year-old male patient who had achieved complete remission from MM following chemotherapy 2 years ago. The EMP was treated successfully with radiotherapy.

Keyword

Plasmacytoma; Maxillary sinus neoplasms; Radiotherapy; Plasma cells; Multiple myeloma

Figure

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  Fig. 1. Preoperative endoscopic and computed tomography (CT) findings. Nasal endoscopy (A) shows bulging of the lateral wall of the right nasal cavity. Axial (B), coronal (C), and sagittal (D) CT images show enhancing masses in the bilateral maxillary sinuses with destruction of the right maxillary sinus wall and extension into the right nasal cavity.

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  Fig. 2. Intraoperative endoscopic findings. Transnasal endoscopic biopsy was performed on the right maxillary mass through inferior meatal antrosotomy using a 0° nasal endoscope (A) and the left maxillary mass through middle meatal antrostomy using a 70° nasal endoscope (B).

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  Fig. 3. Histopathologic findings of extramedullary plasmacytoma. Dense infiltration of mature, immature, atypical plasma cells is seen (A, hematoxylin and eosin, ×400). Positive immunostaining for CD138 is observed (B, ×400). Immunoglobulin light chain restriction is also seen (C, ×400).

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  Fig. 4. Computed tomographic images show no evidence of an enhancing mass in the bilateral maxillary sinuses on axial (A), coronal (B), and sagittal (C) planes. Mucosal thickening in the bilateral maxillary sinuses is noted.

Reference

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