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喉外髓质浆细胞瘤放疗 8 年后转化为多发性骨髓瘤病例。

Case with translating to multiple myeloma at 8 years after radiation therapy for extramedullary plasmacytoma of the larynx.

机构信息

Department of Otorhinolaryngology, Juntendo University of Medicine, Shizuoka Hospital, Izunokuni-shi, Shizuoka, Japan

Department of Pathology, Juntendo University of Medicine, Shizuoka Hospital, Izunokuni, Shizuoka, Japan.

出版信息

BMJ Case Rep. 2024 Feb 19;17(2):e256747. doi: 10.1136/bcr-2023-256747.

Abstract

We report a case of extramedullary plasmacytoma of the larynx that was eradicated by radiotherapy; however, 8 years later, the disease had progressed to multiple myeloma. A mid -60s Japanese woman presented with a right-sided arytenoid mass in the larynx who underwent biopsy at another hospital. Based on the biopsy results, the patient was diagnosed with extramedullary plasma cell tumour and was referred to the Department of Otorhinolaryngology at our hospital. She received radiotherapy (50.4 Gy) and the laryngeal tumour was eradicated. Positron emission tomography/CT (PET-CT) revealed no abnormal accumulation in the larynx or whole body. After radiotherapy, the department of otorhinolaryngology, in consultation with Ddepartment of haematology performed follow-ups using laryngoscope, blood examination and PET-CT. Five years after the end of radiotherapy, the patient had no local recurrence or transition to multiple myeloma. However, 8 years later, blood examination and PET-CT revealed multiple myeloma. Laryngoscopy did not reveal any recurrent laryngeal tumour. Therefore, chemotherapy for multiple myeloma was administered at the department of haematology. Three months after the initiation of chemotherapy, the accumulation had disappeared in PET-CT. Three years have passed since chemotherapy initiation. At present, no recurrence or metastasis was observed in the larynx or whole body.

摘要

我们报告了一例喉外髓性浆细胞瘤,该病例通过放疗得以根治;然而 8 年后,疾病进展为多发性骨髓瘤。一位 60 多岁的日本女性因右侧杓状软骨处的喉肿块而就诊于另一家医院,并进行了活检。基于活检结果,该患者被诊断为髓外浆细胞瘤,并被转至我们医院的耳鼻喉科。她接受了放疗(50.4Gy),喉部肿瘤被消除。正电子发射断层扫描/计算机断层扫描(PET-CT)显示喉部或全身均无异常积聚。放疗后,耳鼻喉科与血液科共同进行了喉镜、血液检查和 PET-CT 随访。放疗结束 5 年后,患者无局部复发或进展为多发性骨髓瘤。然而 8 年后,血液检查和 PET-CT 显示多发性骨髓瘤。喉镜检查未发现喉部肿瘤复发。因此,在血液科进行了多发性骨髓瘤的化疗。化疗开始后 3 个月,PET-CT 中的积聚消失。化疗开始 3 年后,目前在喉部或全身均未观察到复发或转移。

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