Extramedullary manifestations of multiple Myeloma and solitary Plasmacytomas in the head and neck region

Introduction Solitary plasmacytoma or extramedullary manifestation of multiple myeloma is a rare differential diagnosis in the head and neck region. Treatment requires an interdisciplinary approach. This article provides an overview of manifestations in the head and neck region based on a case series of 12 patients and a literature review.

Material & Methods A retrospective data collection was carried out using the clinic's internal operating system. At this 12 patients were identified in a period from 2008 to 2022. Relevant data regarding diagnostics and therapy were collected. A search was conducted on Pubmed & Google Scholar to analize the data in the current literature.

Results The average age was 64 years. Most findings occurred cervically, in the paranasal sinus system or in the nasal cavity. Histologic confirmation was performed during endoscopy, paranasal sinus surgery or transcervically. Solitary plasmacytomas usually underwent surgical treatment with adjuvant radiotherapy and, in individual cases, systemic chemotherapy. In the context of a preexisting multiple myeloma with new extramedullary manifestation, local radiotherapy of the affected area was carried out in every case after previous systemic therapy. The average survival time has increased significantly over the last 30 years, but a cure is still only possible in a few cases.

Discussion The extramedullary manifestation of multiple myeloma & solitary plasmacytomas are rare entities & may mimic other diseases. This differential diagnosis should always be considered. Once a diagnosis has been made, close interdisciplinary collaboration is essential for the treatment decision.

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Artikel online veröffentlicht:
19. April 2024