DIKUL - logo
E-viri
Celotno besedilo
Recenzirano
  • MM-200 Solitary Extramedull...
    Baydoun, Omaya; Baydoun, Ahmad; Adawiye, Ahmad; Samaha, Hanadi; El Hachem, Georges

    Clinical lymphoma, myeloma and leukemia, September 2023, 2023-09-00, Letnik: 23
    Journal Article

    Solitary plasmacytoma is a rare neoplasm of monoclonal plasma cells that falls along the spectrum of plasma cells dyscrasias. Unlike bone plasmacytomas, extramedullary plasmacytomas occur outside the bone marrow in any soft tissue. The aerodigestive tract is the most common site, but any organ, including the parotid gland, may be rarely involved. Extramedullary plasmacytoma lacks the defining features of multiple myeloma or medullary plasmacytoma. Here, we report a case of a 60-year-old man who presented with a mass in the retro-auricular area of 2 months’ duration. On physical examination, a 2-cm mass was palpated in the right parotid area with no palpable cervical lymph nodes. Fine-needle aspiration cytology showed atypical cells. MRI of the head and neck showed a 2x2-cm mass in the parotid tail with features suggestive of muco-epidermoid carcinoma and absence of lymphadenopathies. Total parotidectomy was performed. Histopathological evaluation revealed monoclonal plasma cells expressing kappa immunoglobulin light chains. To complete the workup, serum protein electrophoresis, immunofixation, quantitation of immunoglobulins and urine protein electrophoresis, and Bence-Jones were normal. A whole-body 18F-FDG PET/CT scan did not reveal any other lesions. Bone marrow aspirate and biopsy demonstrated less than 3% clonal plasma cells. A complete blood count showed a normal hemoglobin level. Chemistry screen revealed normal calcium and creatinine levels. A diagnosis of solitary plasmacytoma of the parotid gland was made, and the patient received post-operation radiation therapy to the right parotid area. Because less than 7% of patients with solitary medullary plasmacytoma will develop local recurrence and approximately 10–15% of patients will ultimately develop multiple myeloma, the patient was followed up by laboratory tests and imaging at periodic intervals; he is still in complete remission. Although patients with parotid masses are commonly observed in our practice, parotid plasmacytoma is rare. Despite its rarity, it should be considered in the differential diagnosis of parotid gland tumors. Biopsy, blood tests, and imaging are important in the accurate diagnosis and management of this neoplasm.