Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA,
Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
ORL J Otorhinolaryngol Relat Spec. 2023;85(4):231-237. doi: 10.1159/000530946. Epub 2023 Jun 26.
Solitary plasmacytoma is a rare neoplasm characterized by localized proliferation of monoclonal plasma cells and is classified as solitary bone or solitary extramedullary plasmacytoma. Here, we present two rare cases of plasmacytoma of the head and neck. The first is a 78-year-old male who presented with a 3-month history of epistaxis and progressive obstruction of the right nasal passage. Computerized tomography (CT) imaging revealed a mass in the right nasal cavity with destruction to the maxillary sinus. An excisional biopsy was performed revealing anaplastic plasmacytoma. The second is a 64-year-old male with a past medical history significant for prostate cancer who presented with a 2-month history of left ear pain and progressive non-tender temporal swelling. A PET/CT revealed a highly avid, destructive, and lytic left temporal mass with no other evidence of distant disease. A left temporal craniectomy and infratemporal fossa dissection revealed plasma cell dyscrasia with monoclonal lambda in situ hybridization. Although plasmacytomas are uncommon tumors of the head and neck, they may mimic other entities that require different treatment. Prompt and accurate diagnosis is critical for appropriate therapeutic decisions and prognosis.
孤立性浆细胞瘤是一种罕见的肿瘤，其特征为单克隆浆细胞的局限性增殖，并分为孤立性骨浆细胞瘤或孤立性髓外浆细胞瘤。在此，我们报告两例头颈部浆细胞瘤的罕见病例。第一例为 78 岁男性，因鼻出血和右侧鼻腔进行性阻塞 3 个月就诊。计算机断层扫描（CT）显示右侧鼻腔内有肿块，并破坏了上颌窦。进行了切除活检，结果显示为间变性浆细胞瘤。第二例为 64 岁男性，既往有前列腺癌病史，因左耳疼痛和进行性非触痛颞部肿胀 2 个月就诊。PET/CT 显示左侧颞部高度活跃、破坏性和溶骨性肿块，无远处疾病的其他证据。行左侧颞骨切除术和颞下窝解剖术，显示浆细胞异常，原位杂交显示单克隆 lambda。尽管浆细胞瘤是头颈部少见的肿瘤，但它们可能模仿需要不同治疗的其他实体。及时准确的诊断对于适当的治疗决策和预后至关重要。
