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Primary extramedullary plasmacytoma of the palate
Primary extramedullary plasmacytoma of the palate JUAN SEOANE, MD, BDS, PhD, ALBERTO DE LA CRUZ, MD, MANUEL POMAREDA, MD, PABLO I. VARELA-CENTELLES, BDS, and LUIS PIAS, BDS, La Coruna, Spain
A
55-year-old man had a polypoid-like lesion neighboring the uvula. The lesion was symptomless apart from slight discomfort caused by irritation. In view of the lack of signs of malignancy, surgical removal with security margins was decided. The pathologic study of the excised material showed a mass of tissue covered by squamous mucosa with a small fibrous pedicle (Fig 1). The mass of the tumor was composed of mature plasma cells in a well-vascularized stroma. The immunohistochemical analysis disclosed a pattern of monoclonal reactivity with λ antibodies (Fig 2). A hematologic study of peripheral blood, a bone marrow analysis, a general bone survey, and a study of urine and serum proteins were performed and showed no relevant alterations. Considering these results, a diagnosis of primary extramedullary plasmacytoma of the palate was established. No radiation therapy was undertaken. The patient has been followed up closely with no evidence of recurrence for 2.5 years. Extramedullary plasmacytomas have been found in different locations within the human body. In the oral cavity alone, extramedullary plasmacytomas have been described on the palatal tonsil, gingiva, retromolar pad, lip, tongue, and palate.1-3 Surgical treatment, radiotherapy, or a combination are the most suitable therapies. The clinical behavior of extramedullary plasmacytomas differs widely.4 There are descriptions of patients who have remained disease free from 16 months up to 15 years since treatment.
4. Matthews J, Basu M. Plasma cell lesions within the oral tissues: immunoperoxidase staining of routinely fixed and processed tissue. Oral Surg 1982;54:414-23.
Fig 1. Excised specimen.
REFERENCES 1. Rifa J, Manzano H. Plasmocitoma extramedular del velo del paladar. Med Clin (Barc) 1991;96:478. 2. Batsakis JG. Pathology consultation: plasma cell tumors of the head and neck. Ann Otol Rhinol Laryngol 1983;92:311-3. 3. Cumbo V, Gallina G, Messina P, et al. Le neoplasie plasmacellulari nel distretto oro-facciale: contributo all’inquadramento clinico ed esperienze personali. Stomat Medit 1988;8:307-17. From the Department of Oral and Maxillofacial Surgery, University of Santiago de Compostela, and Otolaryngology Service, Navy Hospital. Reprint requests: Juan Seoane, MD, BDS, PhD, Canton Grande 13/15.Apto 1°E, E-15003 La Coruna, Spain. Otolaryngol Head Neck Surg 1999;120:530. Copyright © 1999 by the American Academy of Otolaryngology– Head and Neck Surgery Foundation, Inc. 0194-5998/99/$8.00 + 0 23/78/87039 530
Fig 2. Mature plasma cells showing monoclonality for λ chains.
A
55-year-old man had a polypoid-like lesion neighboring the uvula. The lesion was symptomless apart from slight discomfort caused by irritation. In view of the lack of signs of malignancy, surgical removal with security margins was decided. The pathologic study of the excised material showed a mass of tissue covered by squamous mucosa with a small fibrous pedicle (Fig 1). The mass of the tumor was composed of mature plasma cells in a well-vascularized stroma. The immunohistochemical analysis disclosed a pattern of monoclonal reactivity with λ antibodies (Fig 2). A hematologic study of peripheral blood, a bone marrow analysis, a general bone survey, and a study of urine and serum proteins were performed and showed no relevant alterations. Considering these results, a diagnosis of primary extramedullary plasmacytoma of the palate was established. No radiation therapy was undertaken. The patient has been followed up closely with no evidence of recurrence for 2.5 years. Extramedullary plasmacytomas have been found in different locations within the human body. In the oral cavity alone, extramedullary plasmacytomas have been described on the palatal tonsil, gingiva, retromolar pad, lip, tongue, and palate.1-3 Surgical treatment, radiotherapy, or a combination are the most suitable therapies. The clinical behavior of extramedullary plasmacytomas differs widely.4 There are descriptions of patients who have remained disease free from 16 months up to 15 years since treatment.
4. Matthews J, Basu M. Plasma cell lesions within the oral tissues: immunoperoxidase staining of routinely fixed and processed tissue. Oral Surg 1982;54:414-23.
Fig 1. Excised specimen.
REFERENCES 1. Rifa J, Manzano H. Plasmocitoma extramedular del velo del paladar. Med Clin (Barc) 1991;96:478. 2. Batsakis JG. Pathology consultation: plasma cell tumors of the head and neck. Ann Otol Rhinol Laryngol 1983;92:311-3. 3. Cumbo V, Gallina G, Messina P, et al. Le neoplasie plasmacellulari nel distretto oro-facciale: contributo all’inquadramento clinico ed esperienze personali. Stomat Medit 1988;8:307-17. From the Department of Oral and Maxillofacial Surgery, University of Santiago de Compostela, and Otolaryngology Service, Navy Hospital. Reprint requests: Juan Seoane, MD, BDS, PhD, Canton Grande 13/15.Apto 1°E, E-15003 La Coruna, Spain. Otolaryngol Head Neck Surg 1999;120:530. Copyright © 1999 by the American Academy of Otolaryngology– Head and Neck Surgery Foundation, Inc. 0194-5998/99/$8.00 + 0 23/78/87039 530
Fig 2. Mature plasma cells showing monoclonality for λ chains.