Solitary Extramedullary Plasmacytoma of the Sphenoid Sinus: A Case Report

Abstract

Solitary extramedullary plasmacytomas are rare, discrete mass of neoplastic monoclonal plasma cells in the soft tissue with no evidence of multiple myeloma. They constitute 3 % of all plasma cell tumors and less than 1 % of head and neck malignancies. A 43 year old lady presented to our clinic with complains of diplopia and headache for 4 weeks. Computed Tomography scan showed a mass lesion in the sphenoid sinus eroding the sinus floor, right wall, basisphenoid and parasellar area. A biopsy of the mass reported as plasmacytoma. Systemic examination revealed no evidence of dissemination of the disease confirming the diagnosis of a solitary extramedullary plasmacytoma. The patient was subjected to 25 fractions of radiotherapy. Here, we report a rare case of solitary extramedullary plasmacytoma of the sphenoid sinus.

Solitary plasmacytoma of the skull base: A case report and literature review

“…[18] M 83 Sphenoid Headaches, diplopia XRT+CT PMM (NA) Ping Loong et al. [19] F 43 Sphenoid Headaches, diplopia XRT 50Gy NA Wein et al. [20] M 48 Sphenoid sinus+clivus Headaches, epistaxis XRT+CT PMM (1) Park et al.…”

Extramedullary plasmacytoma of the sphenoid sinus presenting with visual loss: A case report

“…When the tumor extended, visual loss, diplopia, and facial pain can be presented. 7 , 8 Humphrey et al 9 reported an extramedullary plasmacytoma of the sphenoid sinus that presented with isolated VIth‐nerve paralysis. In our presented case, progressive ocular muscle paralysis and ptosis were the clinical manifestations.…”

“…Moreover, in the localized sphenoid sinus tumor, the symptoms are usually non‐specific. When the tumor extended, visual loss, diplopia, and facial pain can be presented 7,8 . Humphrey et al 9 reported an extramedullary plasmacytoma of the sphenoid sinus that presented with isolated VIth‐nerve paralysis.…”

Sphenoid sinus anatomical variants and pathologies: pictorial essay

“…Local recurrence or spread to other nearby osseous sites may occur. Some of the patients develop multiple myeloma [ 33 ]. The prognosis depends on the tumor size and the nodes' involvement.…”

“…On CT scan, EMPs typically appear as well-defined, polypoid soft-tissue masses, which show homogenous enhancement. A large tumor may show internal areas of necrosis, adjacent bony destruction with infiltration into the adjacent structures, and vascular encasement [ 33 , 34 ] (Fig. 13 ).…”