Extramedullary plasmacytoma of the nasopharynx treated with surgery and adjuvant radiation: Case report and review of the literature

Objectives Extramedullary plasmacytoma (EMP) is a rare neoplasm of plasma cell origin that arises due to soft tissue infiltration of monoclonal plasma cells, in the absence of systemic disease. Although the head and neck is the most common location of EMP, there are only a handful of cases reported in the nasopharynx. This report conveys our recent experience with EMP of the nasopharynx in the context of the limited literature on this topic. Study Design Report of a case and review of the literature Results A 50 year-old healthy male presented with a year-long history of increasing bilateral nasal congestion unresponsive to medical therapy. Nasal endoscopy revealed a large exophytic mass filling both posterior nasal cavities. Imaging demonstrated a 3X3 cm mass arising from the nasopharynx and extending into the posterior nasal cavities bilaterally. A biopsy was performed, demonstrating extramedullary plasmacytoma of the nasopharynx. Metastatic work-up was negative. The patient underwent surgical debulking followed by radiation therapy to the primary site and bilateral necks. He has not recurred to date and does not have evidence of progression to multiple myeloma. Conclusions This report adds to the scant literature on EMP of the nasopharynx, which may mimic many benign nasal and sinus conditions. Although surgery is usually considered second line treatment for EMP of the head and neck, this case demonstrates the utility of surgical debulking in symptom palliation before definitive treatment with radiation.

Duke Scholars

Author Nazish Khalid Hashmi Anesthesiology, Cardiothoracic