Successful management of extramedullary plasmacytoma of the larynx in a patient with advanced radiation therapy techniques

Objective: Extramedullary plasmacytoma (EMP) is a rare variant of plasma cell myeloma that affects soft tissues. The most affected sites of EMP are primarily the head and neck regions. In this study, we report a case of this rare neoplasm in the larynx and its management using an advanced radiation therapy protocol. Methods: A 42-year-old Hispanic female presented with a history of progressive hoarseness for several weeks. Initially the patient underwent endoscopic evaluation of her throat to find any tumour lesion in the region of her false vocal cord. The patient was diagnosed with the presence of EMP of the larynx using microscopic laryngoscopy followed by computed tomography (CT)/positron emission tomography (PET)/magnetic resonance imaging (MRI) and pathological evaluations. Results and discussion: The findings of the endoscopic evaluation and microscopic laryngoscopy of the patient’s throat indicated a submucosal mass in the region of her false vocal cord that was keeping the true vocal cords from adequately apposing. The CT/PET/MRI and pathology evaluations revealed the presence of a stage I EMP of the larynx. Following the diagnosis of her disease, the patient was administered a course of conformal 3-Dimentional intensity modulated radiation therapy (IMRT)/image-guided radiation therapy (IGRT) to a total dose of 5,040 cGy in 28 fractions over 44 calendar days. A post-operative treatment evaluation after more than 7 years indicated no evidence of a recurrent neoplasm or distant metastasis. Conclusion: The findings of this case study demonstrated that conformal 3-D IMRT/IGRT is clinically effective in managing the EMP of the larynx successfully. *Correspondence to: G Kesava Reddy, University Cancer and Diagnostic Centers, Houston, TX, USA, Tel: (713) 474-1414; Fax: (713) 474-8477; E-mail: kreddy_usa@yahoo.com