Abstract
The solitary extramedullary plasmacytoma (SEP) is derived from plasma cells and is included in the category of non-Hodgkin’s lymphoma. SEPs make up 4% of all plasma cell tumors and can occur in any site in the body, but are found mainly in the upper aerodigestive tract (UAD). Chest wall and mediastinal SEPs are extremely rare. Local control rates of 80-100% with radiotherapy are consistently reported due to the highly radiosensitive character of SEP. Less than 30% of SEPs progresses to multiple myeloma (MM), and the 10-year survival rate is around 70%. SEP has a better prognosis than solitary bone plasmacytoma (SBP) and MM. We report a patient with a mediastinal mass extending to the anterior chest wall without bony destruction. Fine-needle aspiration and echo-guided biopsy of the chest wall mass revealed a plasmacytoma. Serum protein electrophoresis demonstrated a spike in immunoglobulin A (IgA) lambda chains. Investigations for multiple myeloma were negative. The final diagnosis was SEP of the anterior mediastinum extending to the anterior chest wall.
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