Primary Solitary Extramedullary Plasmacytoma Involving the True Vocal Cords in a Pregnant Woman

Abstract

Primary solitary extramedullary plasmacytoma of the larynx involving the true vocal cords is an extremely rare entity. Extramedullary plasmacytoma has the potential to transform into multiple myeloma and mandates strict vigilance and routine follow-up. We describe such a case in a 29-year-old pregnant woman who presented with progressive hoarseness, dysphagia and intermittent respiratory difficulty. Fiberoptic laryngoscopy revealed a fleshy mass involving the posterior third of the true vocal cords, encroaching on the ventricle and false cords. Histopathology and immunohistochemistry revealed extramedullary plasmacytoma of a monoclonal nature. In spite of Bence Jones proteinuria and a rising serum β₂-microglobulin level, a thorough search for metastasis and subsequent treatment with radiotherapy were delayed due to the patient's pregnancy. She is the youngest adult ever reported with primary solitary extramedullary plasmacytoma involving the true cords. Described for the first time in pregnancy, the relevant issues in management are highlighted.