頭頸部多發性髓外漿細胞瘤

Multiple Extramedullary Plasmacytomas in Head and Neck

袁建漢(Chien-Han Yuan) ； 莊蕙青(Hui-Ching Chuang) ； 簡志彥(Chih-Yen Chien)

《台灣耳鼻喉頭頸外科雜誌》 40卷2期 (2005/04) Pp. 86-91

https://doi.org/10.6286/2005.40.2.86

摘要

髓外漿細胞瘤大部分發生於頭頸部軟組織，以鼻腔、鼻咽及鼻竇爲好發部位，佔所有頭頸部腫瘤不到1%，約有20-30%會轉變爲多發性骨髓瘤，臨床上要詳細診斷與長期追蹤，治療方式爲手術切除、局部放射線治療、或合併治療。本科經歷1名52歲女性，在後咽壁及右聲門上區有實質腫塊，於2001年8月做手術切除。此外病人鼻塞數年，有鼻涕倒流，且兩側鼻竇有息肉樣病灶，電腦斷層檢查顯示疑有鼻竇炎，於2002年1月執行鼻竇內視鏡手術，術後均確定診斷爲髓外漿細胞瘤。進一步血液、尿液免疫電泳檢查及骨髓抽取檢查，無多發性骨髓瘤的證據。追溯過去病史，病患於7年前及5年前分別接受左腔脛骨漿細胞瘤及右鎖骨漿細胞瘤切除。病患術後接受口咽及喉部局部放射線治療，但拒絕鼻部放射線治療，目前仍持續門診追蹤。因本病例屬於單一骨骼漿細胞瘤術後轉變爲多發性髓外漿細胞瘤，臨床上極爲罕見，特此提出報告。

關鍵字

髓外漿細胞瘤 ； 頭頸部

並列摘要

Extramedullary plasmacytomas arise most frequently in the head and neck region. Most extramedullary plasmacytomas are found in the nasal cavity, nasopharynx, and the paranasal sinuses; they comprise less than 1% of head and neck tumors. Approximately 20 to 30% of patients with extramedullary plasmacytomas may progressively convert to multiple myeloma and require long-term follow-up. The treatment modalities are surgery alone, radiotherapy alone, or combined surgery and radiotherapy. We report a 52-year-old female patient with a posterior pharyngeal wall mass concomitant with a right supraglottic mass and she underwent resection of both tumors in August 2001. Five months later, she was suspected as a case of chronic rhinosinusitis and underwent sinoscopic surgery. Both pathologic reports revealed extramedullary plasmacytomas. Tracing back her history, she underwent excisions of solitary bone plasmacytoma over her left tibia and right clavicle 7 and 5 years ago respectively. Serial hematological examinations were performed and no evidence of multiple myeloma was noted. The patient received postoperative radiotherapy over the oropharynx and larynx, but she refused irradiation over paranasal sinus region. She is regularly followed up in our department and is doing well till now.

並列關鍵字

extramedullary plasmacytoma ； head and neck