Ghatak Soumya, Dutta Mainak, Kundu Indranath, Ganguly Rajendra Prasad
Department of Otorhinolaryngology and Head-Neck Surgery, RG Kar Medical College and Hospital, Kolkata, West Bengal, India.
Tumori. 2013 Jan-Feb;99(1):e14-8. doi: 10.1177/030089161309900126.
Primary solitary extramedullary plasmacytoma of the larynx involving the true vocal cords is an extremely rare entity. Extramedullary plasmacytoma has the potential to transform into multiple myeloma and mandates strict vigilance and routine follow-up. We describe such a case in a 29-year-old pregnant woman who presented with progressive hoarseness, dysphagia and intermittent respiratory difficulty. Fiberoptic laryngoscopy revealed a fleshy mass involving the posterior third of the true vocal cords, encroaching on the ventricle and false cords. Histopathology and immunohistochemistry revealed extramedullary plasmacytoma of a monoclonal nature. In spite of Bence Jones proteinuria and a rising serum β 2-microglobulin level, a thorough search for metastasis and subsequent treatment with radiotherapy were delayed due to the patient's pregnancy. She is the youngest adult ever reported with primary solitary extramedullary plasmacytoma involving the true cords. Described for the first time in pregnancy, the relevant issues in management are highlighted.
累及真声带的原发性孤立性喉外浆细胞瘤是一种极为罕见的疾病。喉外浆细胞瘤有转化为多发性骨髓瘤的可能,因此需要严格监测并进行常规随访。我们报道了这样一例病例,患者为一名29岁的孕妇,表现为进行性声音嘶哑、吞咽困难和间歇性呼吸困难。纤维喉镜检查发现一个肉质肿物,累及真声带后三分之一,侵犯了喉室和假声带。组织病理学和免疫组化显示为单克隆性喉外浆细胞瘤。尽管存在本周氏蛋白尿和血清β2微球蛋白水平升高,但由于患者怀孕,对转移灶的全面检查及随后的放射治疗均被推迟。她是有报道的累及真声带的最年轻的原发性孤立性喉外浆细胞瘤成年患者。本文首次描述了该疾病在孕期的情况,并强调了相关的治疗问题。