Title: Extramedullary Plasmacytoma of the Jugular Bulb- A Rare Case Report

Authors: Dr Syeda Sarah, Anwaruddin Ahmed, Vamseedhar Annam, Sharmila P Surhonne

 DOI: https://dx.doi.org/10.18535/jmscr/v7i4.58

Abstract

Introduction: Extramedullary plasmacytoma (EMP) of jugular bulb is a very rare plasma cell proliferative disorder arising outside the bone marrow.EMP represents less than 1%of head and neck malignancies. More than 90% of EMPs are diagnosed in the head and neck with the soft tissues and upper aero digestive tract being the most common sites. EMPs should be distinguished from other plasma cell dyscrasias for prognosis and treatment. There are very scarce previous documented reports on plasmacytoma arising from jugular bulb. Hence,we present here a rare case report of EMP arising from the jugular bulb masquerading as an extradural space occupying lesion

Case Report: A 56 year old man presented to our hospital with history of neck stiffness, torticollis and progressive nuchal pain since 3 months. Radiological findings identified an extradural expansile mass lesion in the left jugular foramen bulb causing bony erosion. Intraoperative squash cytology suggested a differential diagnosis of small round blue cell tumor. Surgical excision of the mass was performed and sent for histopathological evaluation, which showed features of plasmacytoma. Immunohistochemistry was positive for CD 138 confirming the diagnosis of EMP.

Keywords: Extramedullary Plasmacytoma, Squash Cytology, IHC.

References

  1. Schridde H. Weitere Untersuchungen uber die Kornelungen der Plasmazellen.Centralbl Allg Pathol Anat.1905; 16:433–435.
  2. Susnerwala, S., et al., Extramedullary plasmacytoma of the head and neck region: clinicopathological correlation in 25 cases. British Journal of cancer, 1997. 75(6): p. 921.
  3. International Myeloma Working Group. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma.
  4. Finsinger, P.et al., Clinical features and prognostic factors in solitary plasmacytoma. British journal of haematology, 2016. 172(4): p. 554-560.
  5. Windfuhr JP, Ott G. Extramedullary plasmacytoma manifesting as a palpable mass in the nasal cavity. Ear Nose Throat J 2002; 81:110-4.
  6. Soutar, R., et al., Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. British journal of haematology, 2004. 124(6): p. 717-726.
  7. Ravikishore H, Ashwini S Doddamani, Narendranath A, Unnikrishnan V M. Extramedullary plasmacytoma of the nasal cavity: A rare case report. August 2015;2(8):456-458.
  8. Wiltshaw, E., The natural history of extramedullary plasmacytoma and its relation to solitary myeloma of bone and myelomatosis. Medicine, 1976. 55(3): p. 217-238.
  9. Creston, J.E., The otolaryngologic manifestations of multiple myeloma. The Laryngoscope, 1978. 88(8): p. 1320-1332.
  10. Han, Y.J., et al., Solitary extramedullary plasmacytoma in the gastrointestinal tract: report of two cases and review of literature. The Korean Journal of Gastroenterology, 2014. 63(5): p. 316-320.

Corresponding Author

Dr Syeda Sarah

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