Yahaya Saadat Titilayo, Shofoluwe Nurudeen Adebola, Abdullahi Idris, Omodele Abdurahman, Lawal Jamila, Abdullahi Amina Mohammad, Sanni Rasheedat, Anka Manir Hamza
ENT Department, Lagos State University Teaching Hospital, Lagos, Nigeria.
Division of Ear-Nose and Throat, Department of Surgery, Faculty of Clinical Science, College of Medical Sciences Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
J West Afr Coll Surg. 2025 Oct-Dec;15(4):497-500. doi: 10.4103/jwas.jwas_93_24. Epub 2025 Feb 4.
Extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm occurring outside the bone marrow, predominantly in the head and neck region. Representing 3%-5% of all plasma cell neoplasms, EMP poses significant diagnostic and therapeutic challenges due to its rarity and,proximity to vital structures. We report two cases of EMP involving the nasal cavity, paranasal sinuses, and nasopharynx. A 30-year-old male presented with right diplopia, headache, and bilateral nasal blockage. Examination revealed a nasopharyngeal mass with bony erosion and multiple osteolytic lesions. Histopathology and immunohistochemistry confirmed plasmacytoma, and systemic involvement was excluded. The patient underwent chemoradiotherapy with satisfactory outcomes. A 27-year-old female presented with nasal bleeding, progressive nasal blockage, facial swelling, snoring, and anosmia. Imaging revealed a mass originating from the left maxillary sinus extending to adjacent structures. Histopathology and immunohistochemistry confirmed plasmacytoma. Systemic workup was negative. The patient was treated with radiotherapy, with a good treatment outcomes. EMP of the nasal cavity, paranasal sinuses, and nasopharynx is rare, particularly in younger patients. Accurate diagnosis and appropriate treatment, often involving radiotherapy, are crucial for favorable outcomes. Awareness and a high index of suspicion are essential for early diagnosis and management.
髓外浆细胞瘤（EMP）是一种罕见的浆细胞肿瘤，发生于骨髓外，主要位于头颈部区域。EMP占所有浆细胞肿瘤的3%-5%，由于其罕见性以及与重要结构相邻，给诊断和治疗带来了重大挑战。我们报告了两例累及鼻腔、鼻窦和鼻咽部的EMP病例。一名30岁男性出现右眼复视、头痛和双侧鼻塞。检查发现鼻咽部肿物伴骨质侵蚀和多处溶骨性病变。组织病理学和免疫组化证实为浆细胞瘤，排除全身受累。该患者接受了放化疗，效果满意。一名27岁女性出现鼻出血、进行性鼻塞、面部肿胀、打鼾和嗅觉减退。影像学检查显示一个起源于左上颌窦并延伸至相邻结构的肿物。组织病理学和免疫组化证实为浆细胞瘤。全身检查结果为阴性。该患者接受了放射治疗，治疗效果良好。鼻腔、鼻窦和鼻咽部的EMP较为罕见，尤其是在年轻患者中。准确诊断和适当治疗（通常包括放疗）对于取得良好疗效至关重要。提高认识和高度怀疑对于早期诊断和管理至关重要。
