We report a case of extramedullary plasmacytoma in nasal cavity. A 47-year-old male presented to us with a 3-month history of right nasal obstruction and repeated bleeding from the nose. Nasal endoscopic examination showed a reddish and easily bleeding tumor, about 3 cm in diameter, in the right nasal cavity. Histologic examination of biopsy specimens obtained from the lesion revealed extramedullary plasmacytoma with κ type IgA. Radiation therapy at a total dose of 40 Gy was undertaken, and the nasal tumor disappeared. However, about 3 years after this treatment, the patient was diagnosed as having multiple myeloma with involvement of the ulna, sternum and tibias. We treated the patient with several cycles of chemotherapy including bortezomib or melphalan, followed by autologous peripheral blood stem cell transplantation. As at the time of submission of this case report, the patient remains alive, with stable disease.
Extramedullary plasmacytoma is characterized by malignant transformation of plasma cells. Only 5 cases with extramedullary plasmacytoma in the nasal cavity that went on to develop multiple myeloma on a subsequent date have been reported. The median period from the end of treatment to the development of multiple myeloma was 32 months in the 5 cases. Therefore, long-term follow-up in collaboration with a hematologist is needed for patients diagnosed as having nasal extramedullary plasmacytoma.
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