Szpiczak plazmocytowy w obrębie jam nosa i zatok przynosowych

Abstract

Plasma cell myeloma is a monoclonal neoplastic growth of plasmocytes--classified to a large group of B cell lymphomas. In the majority of cases plasma cell myeloma manifest as a generalized neoplastic disease localized in the bones. Only ca 10% of cases represent a isolated growth within the lymph nodes, skin or mucosa. The most common localization of extramedullary plasmocytoma is a mucosa of the nasal cavity and paranasal sinuses. The rest of myelomas within the nose and sinuses are in fact only one of mulitiple focuses, within a bone frame of the nose and sinuses. Case reports of three cases of plasma cell myeloma localised within the nose and paranasal sinuses; diagnosed and treated in Holy Cross Cancer Center- Kielce, Poland, from 2001 to 2008. The retrospective analysis and current follow up of cases presented. Case I-- Male 49 years old--Extramedullary plasmocytoma localized in mucosa of the floor of nasal cavity. Treated with radical Rtg-therapy. Alive 57 months with symptoms of the disease. Case II--Male 42 years old--Multiple myeloma with one of focuses in anterior wall of maxillary sinus. Treated with radical Rtg-therapy and Chemotherapy. Died due to the primary disease in 2 months. Case III--Male 29 years old--Multiple myeloma with one of the focuses in posterior wall of maxillary sinus. Treated with radical Rtg-therapy and Chemotherapy. Died due to the primary diseases in 16 months. (1) Plasma cell myelomas in the nose and paranasal sinuses region are a rare tumors. They may manifest as an isolated form of plasmocytoma, or a generalized disease as a one of focuses in the bone frame of the nose and sinuses or one of the focuses outside the bone. (2) The complex diagnosis and treatment of plasma cell myelomas require a multispecialistic approach, and should be conducted in oncological centers. (3) The ceases presented confirm, that a generalized myelomas usually have a bad prognosis. In isolated form of plasmocytoma the long remissions or cure may be expected.