case_images: PMC11190079_01
case_images: Fiberoptic examination of the throat tumor. Fiberoptic exam displaying a polypoid throat protruding from the right piriform fossa, partially occluding the vocal slit during phonation. (A) Conventional white-light image. (B) NBI (Narrow Band Imaging) image of the same site.
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case_images: Indirect laryngoscopy and fiberoptic exams revealed a round 2 cm, smooth polypoid mass protruding from the right piriform fossa, partially occluding the vocal slit during phonation ( Figures 1A, B ).
case_images: Histopathological assessment of the tumor. (A-C). Throat tumor biopsy showing sheets of plasma cells. H&E. (x 400). Immunohistochemistry displaying positivity for (D) CD138, (E) lamda, and the (F) absence of kappa light chain expression.
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case_images: The tumor pathological findings confirmed the diagnosis of EMP ( Figures 2A-F ).
case_images: PET scan. PET scan showing increased FDG uptake in a (A, B) soft tissue density lesion in the right throat originating from the right piriform fossa (horizontal section) and in the (C) right cervical lymph node of IIA group (coronal section). Note that no abnormal FDG avid uptake was observed elsewhere, indicating the absence of a distant lesion.
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case_images: The maximum standardized uptake value of the tumor was 7.1 ( Figures 3A, B ).
case_images: Surgical procedure and post-surgical fiberoptic exam. Visualization of the tumor through a laryngoscope, shown (A) during the surgical removal of the tumor and (B) post-removal. (C, D). Fiberoptic examination post-surgery revealing residual tumor tissue.
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case_images: The tumor was visualized and partially removed using microlaryngeal scissors and bipolar coagulation, as complete resection was not feasible, and only a debulking approach was applied ( Figures 4A, B ). Figures 4C, D ). Following this, the patient was referred for a hematological and oncological consultation to proceed with a chemotherapeutic regimen of dexamethasone and bortezomib, but due to severe side effects including numerous bleeding episodes, anemia and dizziness, and the absence of a MM diagnosis, chemotherapy was discontinued after one course.