Vol. 101  No. June  2008

Extramedullary Plasmacytoma of the Epipharynx: 
A Case Report

Kaori Kayano
(Nantan General Hospital)

We report a case of extramedullary plasmacytoma of the epipharynx in an 80-year-old woman. She complained of a sensation of occlusion in the epipharynx. Physical examination, computed tomography, and magnetic resonance imaging showed a mass measuring 15 mm in diameter in the epipharynx without associated cervical lymphadenopathy. Biopsy of the lesion showed extramedullary plasmacytoma. There were no abnormalities with respect to serum immunoglobulin levels, serum or urinary protein levels, or bone marrow biopsy findings. Surgical resection of the tumor was performed by the endoscopic transnasal method with a CO2 laser. Immunohistochemical examination of the resected mass demonstrated monoclonality for immunoglobulin heavy-chain IgG and lambda-light chain in the tumor cells. Additionally, a rearrangement band was identified on Southern blot analysis of tumor extract using the probe for imunoglobulin heavy chain.
Because the surgical margin was positive for tumor cells, additional resection was performed. However, there was no apparent tumor in the further resected tissue specimen. There has not been any sign of local recurrence or development of multiple myeloma 13 months after surgery.
We suggest that surgery is the optimal choice for treating extramedullary plasmacytoma of the head and neck when the tumor is localised and resectability is good.

Key words :
extramedullary plasmacytoma, epipharynx, CO2 laser

第101巻6号 目次   Vol.101 No.6 contents