Extramedullary plasmacytoma involving nasal cavity and orbit

Abstract

Introduction: Extramedullary plasmacytoma (EMP) is a disorder involving plasma cells, leading to the development of neoplastic masses outside the bone marrow. While EMP can occur in different body regions, its predominant manifestation is observed in the head and neck area. A 44-year-old female presented with nasal obstruction, left-sided proptosis, and infraorbital swelling. Rigid nasal endoscopy revealed a polypoidal mass filling both nasal cavities, and imaging showed a uniform density mass lesion involving bilateral sinuses extending into the left orbit. The lesion was resected endoscopically, with subsequent histopathological examination confirming the diagnosis of EMP. Ancillary studies ruled out multiple myeloma (MM). The intraorbital component of the tumour was successfully treated using primary radiotherapy, leveraging the tumours’ inherent radiosensitivity to minimize surgical morbidity.Conclusions: This case underscores the importance of including EMP in the differential diagnosis of sinonasal and other head and neck tumours. The favourable outcome achieved through a combination of surgery and radiotherapy highlights the significance of adopting a multidisciplinary approach in navigating challenging clinical scenarios, ensuring improved patient outcomes.