Plasmocitoma extramedular en base de lengua

Résumé

Introduction: Extramedullary plasmocytoma is a plasma cell neoplasia that arises outside of the bone marrow or bone.The most frequent locations in the otorrinolaryngologist area are nostrils and nasal sinuses. In 80% of the cases solitary plasmocytoma appears like a soft tissue mass. Patient and methods: Case report: An 80-years old male, with ischaemic heart disease, chronic renal failure and hypertension came to the emergency service complaining of fishbone, located in right base of tongue and removed after exploration. A reddish 2 cm mass is observed in the midline.Endoscopy showed up a mass limited to base of tongue, non ulcerated. The MRI revealed a mass in base of the tongue with 2, 5 cm and intense uptake of gadolinium was discovered. Differential diagnosis is established between lingual thyroid and rhabdomyoma.Thyroid pathology is dismissed after thyroid scan. The patient is informed of the need of biopsy/excision and rejects surgery and monitoring. After 1 year and 2 months the patient is admited to Internal medicine, complaining of erratic bone pains. Imaging studies showed multiples bones lesions, also one nodular lesion in the right axila is found with FNAC compatible with lymphoproliferative process. Bone marrow biopsy did not show evidence of neoplasic infiltration. An axilar right adenectomy is performed with pathologist diagnosis of extramedularry plasmocytoma. Results: Local disease evolved to multiple myeloma without bone marrow infiltration. Chemotherapy with VMP protocol is established, after 2 cycles , the patient decide to interrupt treatment. Conclusions: Pharingeal extramedularry plasmocytoma is infrequent manifesting itself in 5% of cases. Taking a biopsy in deep is essential for diagnosis, as plasmacytoma sits in the submucosa.