A Case of Laryngo-tracheal Involvement of Multiple Myelomas

Abstract

Multiple myelomas arise from neoplastic plasma cells growing in the bone marrow, plasmacytomas arise from neoplastic plasma cells growing in the bone except the bone marrow, or the soft tissues, and plasmacytic leukemia arises from plasma cells growing in the peripheral blood. Neoplastic plasma cells localized within the soft tissue are particularly called extramedullary plasmacytomas. The exramedullary plasmacytoma often arises in the head and neck. There are some reports on extramedullary plasmacytomas arising from the nasal cavity, the paranasal sinus, the pharynx, and the larynx, while it is a very rare case in which multiple myeloma involves the larynx and the trachea. A 72-year-old woman consulted the department of otorhinolaryngology in NHO Kure Medical Center complaining of hoarseness. She had been treated for multiple myelomas for two years previously at the department of hematology in our hospital. An angiogenic-like tumor almost obstructed the larynx and an emergency tracheotomy was performed. The subsequent biopsy revealed the tumor was a plasmacytoma. The patient received radiotherapy (50Gy) on the larynx. The tumor size was almost unchanged just after the end of the radiotherapy whereas the tumor had completely disappeared a month after the radiation. Another lesion arose from the trachea a year after the treatment of the larynx. Radiotherapy (50Gy) was performed on the tracheal lesion as well. The patient is currently surviving without any recurrences in either the larynx or the trachea.