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Extramedullary Plasmacytomas of the Nasal Cavity: Case-Based Perspectives into Optimizing the Diagnostic Differentiation from Inflammatory Polyps

Title: Extramedullary Plasmacytomas of the Nasal Cavity: Case-Based Perspectives into Optimizing the Diagnostic Differentiation from Inflammatory Polyps
Authors: Carmen Aurelia Mogoantă; Codruț Sarafoleanu; Andrei Osman; Irina Enache; Shirley Tarabichi; Constantin-Ioan Busuioc; Ilona Mihaela Liliac; Dan Iovanescu; Ionuţ Tănase
Source: Medicina ; Volume 61 ; Issue 8 ; Pages: 1406
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2025
Collection: MDPI Open Access Publishing
Subject Terms: sinonasal extramedullary plasmacytoma; unilateral nasal mass; differential diagnosis; solitary plasmacytoma; sinonasal tumors; head and neck oncology; histopathological diagnosis; radiotherapy outcomes; endoscopic tumor resection
Description: Background and Objectives: Extramedullary plasmacytoma (EMP) is a rare monoclonal B-cell neoplasm that typically affects the head and neck region, with a predilection for the sinonasal tract. Clinical presentation is often nonspecific, leading to delayed diagnosis. This study aims to improve our understanding of sinonasal EMP by reviewing the recent literature and presenting a case series from our clinical experience. Materials and Methods: A systematic review of published cases of sinonasal EMP from 2000 to 2023 was conducted using the PubMed database, yielding 28 eligible cases. Additionally, we retrospectively analyzed three patients diagnosed and treated at our institutions. Inclusion criteria included histologically and immunohistochemically confirmed EMP without evidence of systemic multiple myeloma. Data on demographics, tumor location, symptoms, treatment, and outcomes were collected and analyzed descriptively. Results: Sinonasal EMP most commonly presented with unilateral nasal obstruction and epistaxis. Tumors were primarily located in the nasal cavity and paranasal sinuses, often extending beyond a single anatomical site. In the literature cohort, the most frequent treatment was combined surgery and radiotherapy (35.71%), followed by radiotherapy alone (17.86%). Recurrence was reported in 10.71% of cases, and 7.14% of patients died due to disease progression. All three patients in our case series underwent surgical excision; two received postoperative radiotherapy. No recurrences or progression to multiple myeloma were observed during follow-up (12–24 months). Conclusions: Sinonasal EMP is a rare but radiosensitive tumor with a favorable prognosis when treated with surgery and/or radiotherapy. Early diagnosis, histopathological confirmation, and exclusion of systemic disease are essential. Multidisciplinary management and long-term follow-up are critical due to the risk of recurrence and transformation into multiple myeloma.
Document Type: text
File Description: application/pdf
Language: English
Relation: Surgery; https://dx.doi.org/10.3390/medicina61081406
DOI: 10.3390/medicina61081406
Availability: https://doi.org/10.3390/medicina61081406
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.89DA088A
Database: BASE