Solitary extramedullary plasmacytoma of the nasopharynx: A case report and literature review

Solitary plasmacytoma (SP) is a plasma cell disorder characterized by a localized accumulation of neoplastic monoclonal plasma cells in bone or soft tissues, without systemic involvement or end-organ damage. SPs are classified into two groups: solitary bone plasmacytoma (SBP) and solitary extramedullary plasmacytoma (SEP). SEP, a less common presentation (20% to 30% of cases), occurs predominantly in the head and neck region (such as the nasal cavity, paranasal sinuses, and nasopharynx) but can also arise, though rarely, in soft tissues, the gastrointestinal tract, skin, and lymph nodes. Cervical lymph node involvement is observed in 10-15% of head and neck SEP cases. Common symptoms include epistaxis, rhinorrhea, nasal obstruction, sore throat, dysphonia, and hemoptysis. Definitive radiation therapy is the standard treatment, offering long-term local control and potentially curative outcomes in extramedullary cases. This case report presents a 39-year-old female with persistent nasal obstruction, later diagnosed with nasopharyngeal extramedullary plasmacytoma. The patient underwent exclusive radiation therapy, resulting in a satisfactory outcome. Additionally, we review the current literature on the definition, diagnosis, management, follow-up procedures, and perspectives of solitary extramedullary plasmacytoma, with a focus on ILROG recommendations guiding best practices in the use of radiation therapy for SEP.