Abstract
We report a 53-year-old man who suffered from right axillary lymph node swelling. Precise examination revealed a chest wall tumor. The result of needle biopsy of the chest wall tumor was a small cell carcimona of unknown origin. After chemo-radiotherapy with minor response, we performed an operation. In the operation, we resected the three ribs involved with a more than 2cm safety margin and performed reconstruction using composite mesh, covering by a pedicled latissimus dorsi myocutaneous flap. The resected specimen was 17×10cm in size. The pathological diagnosis with immunohistochemistry was plasmacytoma (IgA, lambda type). It is difficult to diagnose solitary plasmacytoma of the chest wall preoperatively, and because of both the shift to multiple myeloma and high recurrent rate after radiation therapy alone, multimodality treatment including surgical resection is needed in its management. In this case, it took about 6 months from biopsy to surgery for chest wall tumor, which made us realize the importance and difficulty of diagnosis of solitary plasmacytoma preoperatively.
