Rare tracheal tumor: Solitary plasmacytoma

Multiple airway plasmacytomas: A rare cause of proximal airway obstruction requiring tumor debulking

Extramedullary plasmacytomas (EMP) can present as airway lesions causing central airway obstruction. Though typically solitary, EMPs should be considered in the evaluation of multifocal tracheobronchial tumors. Bronchoscopic tumor debulking and radiation therapy can be used for symptomatic relief.

Radical resection of solitary tracheal extramedullary plasmacytoma under non-intubated anesthesia: a case report

Extramedullary plasmacytoma (EMP) is an uncommon monoclonal plasma cell malignancy that arises outside of the bone marrow. Rarely, EMPs can occur in the trachea, resulting in severe respiratory distress. Due to a small number of cases, the optimal management of tracheal EMP remains a topic of debate. Here, we report a rare case of solitary tracheal EMP causing symptoms of cough, sputum, paroxysmal nocturnal dyspnea, and progressive exertional dyspnea in a 65-year-old male patient. Computerized tomography and fibro bronchoscopy indicated a pedicled nodular mass on the anterior tracheal wall obstructing over 95% of the lumen. The patient was soon successfully managed with partial tracheal resection and reconstruction surgery under non-intubated anesthesia and was diagnosed as EMP by histopathology of the resected mass. Additional laboratory tests excluded the diagnosis of multiple myeloma (MM). There are no signs of recurrence after 6 months of follow-up. Although traditional intubated anesthesia with single-lung mechanical ventilation has been widely applied to radical surgery for tracheal tumors, it is associated with a higher incidence of intubation-related complications and thus prolongs the surgical procedure and postoperative recovery. In this article, we reported the application of tracheal resection and reconstruction under non-intubated anesthesia for the treatment of tracheal EMP, which was proved to be feasible and safe. Non-intubated anesthesia for tracheal resection and reconstruction is likely to be an alternative minimally invasive option for patients with tracheal EMP involving central airways.

Multiple extramedullary plasmacytomas of the trachea and pharyngeal tissue: a case report and literature review

Extramedullary plasmacytoma (EMP) is an infrequent form of plasma cell dyscrasia that presents as a mass of monoclonal plasma cells located in extramedullary soft tissues with no skeletal component. EMP constitutes ~4% of all plasma cell neoplasms and occurs mostly in the upper respiratory tract. Here, we report a rare case of multiple EMPs involving the trachea, laryngopharynx, and oropharynx, which caused symptoms of airway obstruction as the only clinical manifestation. The patient was diagnosed by histopathology of the tissue from bronchoscopic resection and successfully managed with bronchoscopic intervention to treat lesions in the trachea and radiotherapy combined with surgical resection to treat lesions in the pharynx. There was no recurrence after 14 months of follow-up. Endoscopic intervention plays a key role in the rapid diagnosis and treatment of EMP involving the central airways.