AbstractThe Extramedullary Plasmacytomas (EP) are rare tumors originating from plasmacells of the soft tissues outside of the bone. For a correct diagnosis biopsy is mandatory and CT or MRI is necessary.We report a case of a 62 year-old man, who underwent to otolaryngologist visit for nose bleeding. A peduncolated right palatine tonsillar lesion was diagnosed. The nasopharyngeal examination revealed another mass extending inferiorly from the left fossa of Rosenmuller, confirmed by a facial and neck CT. An excisional biopsy was performed in both sites and the histological examination diagnosed a moderately differentiated extramedullary plasmocytoma. Patient was referred to hematologist, which requires a 18F-FDG PET-CT that shows tracer accumulation only in the tonsillar region bilaterally. Bone scintigraphy and bone marrow biopsy were negative.Finally, the patient was referred to our Department and submitted to radiation treatment. Therapy was performed with 3-D conformal technique. The total dose administered was 45 Gy in 25 fractions. The EP is a radiosensitive disease. Several studies show an excellent local control and a long-term disease-free survival after radiotherapy, but there are still not standardized doses and volumes of radiation.All retrospective reviews support radiation doses of 40-50 Gy, supporting irradiation of involved lymph nodes. Higher doses are indicated for high dimensions tumors (> 5 cm) or patients with high risk of recurrence. Studies on the role of surgery are conflicting and there is no evidence on the efficacy of adjuvant chemotherapy. Patient was free from recurrence 30 months after the end of radiation treatment

Extramedullary Plasmacytoma of the Waldeyer’s Ring: A Case Report

SPATOLA, CORRADO;PRIVITERA, Giuseppe
2014-01-01

Abstract

AbstractThe Extramedullary Plasmacytomas (EP) are rare tumors originating from plasmacells of the soft tissues outside of the bone. For a correct diagnosis biopsy is mandatory and CT or MRI is necessary.We report a case of a 62 year-old man, who underwent to otolaryngologist visit for nose bleeding. A peduncolated right palatine tonsillar lesion was diagnosed. The nasopharyngeal examination revealed another mass extending inferiorly from the left fossa of Rosenmuller, confirmed by a facial and neck CT. An excisional biopsy was performed in both sites and the histological examination diagnosed a moderately differentiated extramedullary plasmocytoma. Patient was referred to hematologist, which requires a 18F-FDG PET-CT that shows tracer accumulation only in the tonsillar region bilaterally. Bone scintigraphy and bone marrow biopsy were negative.Finally, the patient was referred to our Department and submitted to radiation treatment. Therapy was performed with 3-D conformal technique. The total dose administered was 45 Gy in 25 fractions. The EP is a radiosensitive disease. Several studies show an excellent local control and a long-term disease-free survival after radiotherapy, but there are still not standardized doses and volumes of radiation.All retrospective reviews support radiation doses of 40-50 Gy, supporting irradiation of involved lymph nodes. Higher doses are indicated for high dimensions tumors (> 5 cm) or patients with high risk of recurrence. Studies on the role of surgery are conflicting and there is no evidence on the efficacy of adjuvant chemotherapy. Patient was free from recurrence 30 months after the end of radiation treatment
2014
Extramedullary plasmacytoma; Hematology; Otolaryngology; Radiation therapy
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/43425
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