Extramedullary Plasmacytoma of Gingiva and Soft Tissue in Neck

Abstract

A 65-year-old female of Indian origin visited the Out Paitent Department of M.R. Ambedkar dental college, Bangalore (India) in the year 2007 with a complaint of a growth in her lower jaw front teeth region since four months. It started as a small growth which gradually increased to the present size and the patient had no other associated symptoms like pain, difficulty in chewing, speech or deglutition. No treatment was taken for the same. She also noticed a swelling in the neck two months prior to the onset of the intra oral swelling and was also not associated with any symptoms of that or any other similar lesions anywhere in the body [Table/ Fig-1].On general examination a solitary swelling was found on left side of the neck, approximately measuring about 2cm in diameter. Its borders were not well demarcated. Inferiorly it was 3cm above the clavicle, medially about 4cm away from the midline and superiorly it up extended to the level of the thyroid cartilage. Skin over the swelling appeared to be normal. On palpation inspectory findings were confirmed. There was no local rise of temperature. It was soft in consistency, non-tender and skin over the swelling was pinch able. Lymph node examination revealed sub mental and right submandibular lymph nodes palpable, about 0.5cm diameter, firm, fixed and non tender.

Fine‐needle aspiration cytology for the diagnosis of plasma cell neoplasms in the head and neck region: A systematic analysis of the literature

“…The electronic searches yielded 1143 articles (PubMed: 418, Web of Science: 292, Embase: 265, and Scopus: 168) and 82 studies reporting 102 individuals were included in this systematic review 17–98 (Figure 1).…”

“…28,30,53,64,72,78,104 Moreover, an extensive radiolucent area with an irregular and destructive pattern has been documented. 22,23,25,26,29,31,35,38,[42][43][44]60,83,92,94,105 The most common features found in our review were an expansive mass along with osteolytic/ill-defined appearances. 23,25,26,29,31,35,38,[42][43][44]60,83,92,94 Tillawi et al, 93 for instance, described a case of cervical plasmacytoma as a large, irregular, expansive, infiltrating, heterogenous bone lesion that had destroyed the fourth cervical vertebral body and extended into the adjacent soft tissues.…”

“…A recent systematic review identified concordance rates higher than 64% for the smear and 77% for the cell‐block technique regarding diagnostic capability for the evaluation of intraosseous jaw lesions, including malignant lesions 16 . Despite several published reports on the cytopathological diagnosis of PCN, either in isolated manifestations (extramedullary or solitary bone plasmacytoma) or as a consequence of PCM, 17–98 there is a lack of compiled information investigating the agreement of cytopathological and histopathological findings, along with others ancillary cytological methods such as smears and cell blocks. In fact, FNAC represents a faster, cheaper and more diversified noninvasive diagnostic approach.…”

Severe Gingival Swelling and Erythema

“…9 There are 3 variants of plasma cell neoplasms including multiple myeloma, medullary plasmacytoma (also known as solitary bone plasmacytoma), and extramedullary plasmacytoma (EMP). 10 Extramedullary plasmacytoma, sometimes referred to as extraosseous plasmacytoma, is described as a solitary or multiple plasma cell neoplasm contained in the soft tissue. Its occurrence is rare, accounting for only 3% of plasma cell neoplasms.…”

“…Extramedullary plasmacytoma lesions are very sensitive to radiotherapy, and the 10-year survival rate is approximately 70%. 10…”