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case_images: Photographs of the patient prior to surgery highlight the right nasal tumor with intact overlying skin.
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case_images: On local examination, he had a shining mass without a breach in the skin (Figure 1), and it was mildly tender and bleeding easily.
case_images: The CT scan images of the patient demonstrate the different views of the soft tissue sinonasal mass obstructing the nasal airway.
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case_images: The mass was extending to the right maxillary sinus and was associated with the destruction of the right turbinates, nasal bone, medial wall of the right maxillary sinus, and nasal septum (Figure 2).
case_images: Histopathology of the tumor demonstrates diffuse proliferation of large atypical plasma cells that are moderately differentiated; H&E staining at 400x original magnification.
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case_images: Histopathology of the biopsy demonstrated a diffuse infiltrate of neoplastic plasma cells (Figure 3).
case_images: Photomicroscopy highlights strong immunostaining of the tumor cells with CD38 (A), and CD138 (B) antibodies respectively.
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case_images: The tumor cells expressed strong immunoreactivity with CD38 and CD138 (Figure 4), but were negative with CD19, CD20, and CD45.
case_images: Photographs of the patient taken during the operation (A-C), the resected specimen (D), and the appearance of the patient immediately after surgery (E-F) and after one week of surgery (G-H).
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case_images: A wide local excision was not feasible; thus, the tumor was extirpated in piecemeal from the nasal cavity, maxillary sinus, and ethmoid sinus components [Figures 5A-C]. The resected tumor specimen (Figure 5D) was submitted for histopathology. The wound was closed with vicryl 3-0 and prolene 6-0 sutures [Figure 5E]. On day 7 postoperatively (Figures 5F-H), the wound sutures were removed, and the patient was discharged.