Plasmacytoma, which is also called “myeloma”, is a tumor composed of plasmacytelike cells, displaying varied phases of differentiation. It is rare that it solitarily occurs in the maxilla. Below is outlined our case of plasmacytoma.
The patient was a female, aged 52. In January 1983, she visited our Department complaining of a small chicken egg-sized swelling extending from the left buccal region to left upper molrs site. The present illness and the X-ray film made us suspect the ameloblastoma. From the results of twice attempted biopsies, the authors obtained findings of an amyloid tumor displaying infiltration by lymphocytes and plasmacytes. The amyloid tumor generally develops as a partial symptom of systemic amyloidosis. But the general physical examination performed by the Internal Medicine of our University, in accordance with our request, resulted in strong suspicions of a solitary plasmacytoma.
In June 1983, under general anesthesia, the tumor was extirpated. It was composed of plasmacyte cells, and exmination for immunoglobulin, by the PAP method, detected monoclonal production of a IgG, λ chain, and the diagnosis of plasmacytoma was established. A large amount of amyloid, which wrapped the external side of the plasmacytoma, was produced by the tumor itself. The sedimentation of this substance, in a large amount, made bioptic diagnosis difficult. Two months after the tumor relapsed, irradiation in total dose of 5, 600 rad, and re-extirpation of the assumedly remaining tumorous tissue were performed.
The postoperative course was satisfactory up to date, after an operation 2 years and 5 months previously.
The present case is characterized by the facts that the formation of a large amount of amyloid around the plasmacytoma made the diagnosis difficult, and that it was rarely visible solitarytype plasmacytoma which developed in the maxilla with IgG.λ chain being monoclonally observed in the cytoplasm by immunohistochemical methods.