PRIMARY EXTRAMEDULLARY PLASMACYTOMA IN THE MIDDLE-EAR - DIFFERENTIAL-DIAGNOSIS AND MANAGEMENT

Primary extramedullary plasmacytoma (PEP) is an uncommon neoplasm of p lasma cell origin which afflicts the head and neck mainly. In this stu dy we report a rare case of a 34-year-old man who presented with left ear tinnitus, hearing loss, blocked feeling and headache. Exploratory tympanotomy revealed a mass extending into the attic and the mastoid a ntrum. Following canal wall-up mastoidectomy, the tumour was carefully removed. Histological examination (including immunoperoxidase stainin g) and thorough clinical, laboratory and radiological evaluation revea led an exclusively cytoplasmic monoclonal IgG immunoglobulin PEP. The combination of surgery (including a second-look procedure) and radioth erapy used in this case may be an over-treatment. However, the patient is still disease-free seven years after his first admission to hospit al.