Zusammenfassung
Plasmozytome der großen Speicheldrüsen sind sehr selten. Bisher sind nicht mehr als vier Fälle beschrieben worden. Es wird ein Fall eines extramedullären Plasmozytoms der Ohrspeicheldrüse vorgestellt, das sich durch einen besonders aggressiven Krankheitsverlauf auszeichnete und innerhalb eines Jahres ad exitum führte. Alternative Behandlungsformen (Operation und Bestrahlung) werden an Hand der vorliegenden Fallberichte diskutiert.
Summary
Extramedullary plasmocytomas of the salivary glands are extremely rare. Not more than four cases have been described in the literature. A further case of an extended extramedullary plasmocytoma of the parotid gland is presented. Radiotherapy of 40 Gy was sufficient for a complete remission of this tumour. Only three months later, however, the patient developed multiple medullary plasmocytoma, which could not be influenced by cytostatic drug treatment. Twelve months after diagnosis, the patient died from medullary plasmocytoma, but without any signs of local recurrence in the parotid gland. The prognosis of extramedullary plasmocytomas of the salivary glands seems to be poor, as about half of the presented cases developed multiple medullary plasmocytoma. Local recurrence at the primary site, however, was not seen in any case. Surgical treatment of extramedullary plasmocytomas of the salivary glands is recommended for those cases where complete removal of the tumour masses seems possible without greater functional damage. Extended plasmocytomas, especially of the parotid gland, should be treated by radiotherapy. They have an excellent radiosensitivity, and the high risk of multiple medullary plasmocytoma in these cases does not seem to justify a mutilating surgery including hemimandibulectomy or sacrifice of the facial nerve.
