Belić Branislav, Mitrović Slobodanka, Arsenijević Snezana, Erdevicki Ljiljana, Stojanović Jasmina, Stojanović Stevan, Stolić Radojica
Faculty of Medicine, University of Pristina/Kosovska Mitrovica, Kosovska Mitrovica, Serbia.
Vojnosanit Pregl. 2013 Feb;70(2):221-4. doi: 10.2298/vsp1302221b.
Plasmacytomas are malignant tumors characterized by abnormal monoclonal proliferation of plasma cells. They originate in either bone--solitary osseous plasmacytoma, or in soft tissue--extramedullary plasmacytoma (EMP). EMP represents less than 1% of all head and neck malignancies.
We presented a case of EMP of the nasal septum in a 44-year-old male who had progressive difficulty in breathing through the nose and frequent heavy epistaxis on the right side. Nasal endoscopy showed dark red, soft, polypoid tumor in the last third of the right nasal cavity arising from the nasal septum. The biopsy showed that it was plasmacytoma. Bence Jones protein in the urine, serum electrophoresis, bone marrow biopsy, skeletal survey and other screening tests failed to detect multiple myeloma. This confirmed the diagnosis of EMP. The mass was completely removed via an endoscopic approach, and then, 4 week later, radiotherapy was conducted with a radiation dose of 50 Gray. No recurrence was noted in a 3-year follow-up period.
EMP of the nasal cavity, being rare and having long natural history, represents a diagnostic and therapeutic challenge for any ear, nose and throat surgeon. Depending on the resectability of the lesion, a combined therapy is the accepted treatment.
浆细胞瘤是一种以浆细胞异常单克隆增殖为特征的恶性肿瘤。它起源于骨骼（孤立性骨浆细胞瘤）或软组织（髓外浆细胞瘤，EMP）。EMP占所有头颈部恶性肿瘤的比例不到1%。
我们报告了一例44岁男性鼻中隔EMP病例，该患者出现进行性鼻通气困难和右侧频繁严重鼻出血。鼻内镜检查显示，右侧鼻腔后三分之一处有暗红色、柔软、息肉样肿物，起源于鼻中隔。活检显示为浆细胞瘤。尿液本-周蛋白、血清电泳、骨髓活检、骨骼检查及其他筛查试验均未发现多发性骨髓瘤。这证实了EMP的诊断。通过内镜手术将肿物完全切除，4周后进行放射治疗，放射剂量为50格雷。在3年的随访期内未发现复发。
鼻腔EMP罕见，自然病程长，对任何耳鼻喉科医生来说都是一个诊断和治疗挑战。根据病变的可切除性，联合治疗是公认的治疗方法。
