Merrot O, Fayoux P, Maetz B, Darras J, Chevalier D
Service d'ORL et de chirurgie cervico-faciale, (Pr A. Desaulty), Hôpital Huriez, Place Polonovski 59037 Lille cedex, France.
Ann Otolaryngol Chir Cervicofac. 2002 Nov;119(5):296-300.
Plasmocytomas are either medullary (disseminated form) or extramedullary with or without bone infiltration (located form). Plasmocytoma is not a common tumor but extramedullary forms mostly occur in the upper respiratory tract without specific manifestations.
The aim of this study is to discuss the management (diagnostic and therapeutic) and the follow-up of extramedullary nasal plasmocytoma.
We report a case of a 71-year-old patient with unilateral nasal obstruction manifestation.
Endonasal biopsy concluded plasma cell tumor without extension on CT scan. Treatment consisted of external nasal surgery and radiotherapy.
Diagnosis of solitary extramedullary plasmocytoma can only be confirmed when the presence of systemic disease is excluded by performing clinical, biological (marrow bone biopsy) and radiological investigations. The treatment should be based on surgery with complementary radiotherapy if there is a skull base erosion. Long term follow-up is necessary because of the high risk of diffuse marrow involvement (multiple myeloma) which may occur after a long delay.
浆细胞瘤分为髓质型（播散型）或髓外型，后者可伴有或不伴有骨浸润（局限型）。浆细胞瘤并不常见，但髓外型大多发生在上呼吸道，且无特异性表现。
本研究旨在探讨鼻髓外浆细胞瘤的处理（诊断与治疗）及随访。
我们报告一例71岁单侧鼻塞表现的患者。
鼻内活检诊断为浆细胞瘤，CT扫描未见病变扩展。治疗包括鼻外手术及放疗。
只有通过临床、生物学（骨髓活检）及影像学检查排除系统性疾病后，才能确诊孤立性髓外浆细胞瘤。若有颅底侵蚀，治疗应基于手术并辅以放疗。由于存在延迟较长时间后发生弥漫性骨髓受累（多发性骨髓瘤）的高风险，长期随访是必要的。
