舌に生じた孤立性形質細胞腫例

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  • A Case of Solitary Plasmacytoma of the Tongue
  • シタ ニ ショウジタ コリツセイ ケイシツ サイボウ シュレイ

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<p>Solitary plasmacytoma occurs in the soft tissues in about 2%–5% of cases, but in about 60% of these cases, they occur in the head and neck region, so that they are often seen by otorhinolaryngologists. However, reports of solitary plasmacytoma arising from the tongue are so few, that they are rarely listed in the differential diagnosis of tongue tumors. Herein, we report a case of solitary plasmacytoma of the tongue.</p><p>The patient was a 44-year-old woman who presented with a white lesion on the left edge of tongue that she had first noticed 10 years earlier. She was diagnosed as having lichen planus by a dentist and treated conservatively. However, as the lesion became painful, she was referred to our department. A 12 × 10 mm lesion with erosion on the surface was observed on the left edge of the tongue, and the findings of biopsy led to the suspicion of plasmacytoma. Contrast-enhanced CT and MRI scan showed a slightly enhancing lesion. No cervical lymphadenopathy was observed. The lesion was excised with a safety margin under general anesthesia, and histopathology confirmed the diagnosis of plasmacytoma. Blood and urine tests showed no evidence of organ or tissue impairment, and serum M protein and urinary Bence-Jones protein were negative. Bone marrow examination showed no atypical cells. FDG-PET/CT showed no obvious abnormal accumulation. Based on these findings, multiple myeloma was ruled out and the patient was diagnosed as having solitary plasmacytoma of the tongue. We have followed her with no additional treatment and have not seen any evidence of recurrence or progression to multiple myeloma for 3 years after the surgery. However, even if solitary plasmacytoma could be controlled locally, progression to multiple myeloma is difficult to predict. Therefore, patients with solitary plasmacytoma require careful follow-up after local treatment.</p>

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