Plasmacytoma of the Temporal Bone, a Great Imitator: Report of Seven Cases and Comprehensive Review of the Literature

Alex D. Sweeney, Jacob B. Hunter, S. Vincent Rajkumar, John I. Lane, Dragan Jevremovic, Matthew L. Carlson

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Objectives: To describe the clinical presentation, radiological features, and outcome of patients with plasmacytoma of the temporal bone. Methods: Multicenter retrospective case series of all patients diagnosed with plasmacytoma of the temporal bone between 1990 and 2015. Comprehensive literature review of all previously published cases. Results: A total of seven patients (average age, 57.3 yr; 57% women) met inclusion criteria. Three (43%) had a known history of multiple myeloma (MM). The most common symptoms at presentation included otalgia, headache, and dizziness (43%, each). Five (71%) presented with a vascular appearing middle ear mass visible on otoscopy. Four of these patients did not have an established history of MM and were referred with presumptive diagnoses of paraganglioma or endolymphatic sac tumor (ELST). The average maximum tumor diameter was 3.7 cm (median, 3.5 cm; range, 0.9-6.6 cm) and the most commonly involved temporal bone subsites were the middle ear and mastoid (71% each). MM was ultimately diagnosed in six cases (86%). In addition to the new cases presented herein, 18 previously published reports were analyzed. In the 25 aggregate cases, 44% of cases were associated with MM, and the mastoid (72%) and middle ear (53%) were the most commonly involved temporal bone subsites. Conclusion: Plasmacytoma of the temporal bone is rare, and the clinical presentation can closely mimic that of other primary temporal bone tumors. In patients with an established history of MM, it is imperative to have a high index of suspicion for temporal bone plasmacytoma, even when radiological features suggest an alternate diagnosis.

Original languageEnglish (US)
Pages (from-to)400-407
Number of pages8
JournalOtology and Neurotology
Volume38
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

Plasmacytoma
Temporal Bone
Multiple Myeloma
Middle Ear
Mastoid
Otoscopy
Earache
Endolymphatic Sac
Paraganglioma
Neoplasms
Dizziness
Blood Vessels
Headache

Keywords

  • Cranial base
  • Extramedullary plasmacytoma
  • Lateral skull base
  • Solitary plasmacytoma
  • Temporal bone malignancy

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Plasmacytoma of the Temporal Bone, a Great Imitator : Report of Seven Cases and Comprehensive Review of the Literature. / Sweeney, Alex D.; Hunter, Jacob B.; Vincent Rajkumar, S.; Lane, John I.; Jevremovic, Dragan; Carlson, Matthew L.

In: Otology and Neurotology, Vol. 38, No. 3, 01.03.2017, p. 400-407.

Research output: Contribution to journalReview article

Sweeney, Alex D. ; Hunter, Jacob B. ; Vincent Rajkumar, S. ; Lane, John I. ; Jevremovic, Dragan ; Carlson, Matthew L. / Plasmacytoma of the Temporal Bone, a Great Imitator : Report of Seven Cases and Comprehensive Review of the Literature. In: Otology and Neurotology. 2017 ; Vol. 38, No. 3. pp. 400-407.
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abstract = "Objectives: To describe the clinical presentation, radiological features, and outcome of patients with plasmacytoma of the temporal bone. Methods: Multicenter retrospective case series of all patients diagnosed with plasmacytoma of the temporal bone between 1990 and 2015. Comprehensive literature review of all previously published cases. Results: A total of seven patients (average age, 57.3 yr; 57{\%} women) met inclusion criteria. Three (43{\%}) had a known history of multiple myeloma (MM). The most common symptoms at presentation included otalgia, headache, and dizziness (43{\%}, each). Five (71{\%}) presented with a vascular appearing middle ear mass visible on otoscopy. Four of these patients did not have an established history of MM and were referred with presumptive diagnoses of paraganglioma or endolymphatic sac tumor (ELST). The average maximum tumor diameter was 3.7 cm (median, 3.5 cm; range, 0.9-6.6 cm) and the most commonly involved temporal bone subsites were the middle ear and mastoid (71{\%} each). MM was ultimately diagnosed in six cases (86{\%}). In addition to the new cases presented herein, 18 previously published reports were analyzed. In the 25 aggregate cases, 44{\%} of cases were associated with MM, and the mastoid (72{\%}) and middle ear (53{\%}) were the most commonly involved temporal bone subsites. Conclusion: Plasmacytoma of the temporal bone is rare, and the clinical presentation can closely mimic that of other primary temporal bone tumors. In patients with an established history of MM, it is imperative to have a high index of suspicion for temporal bone plasmacytoma, even when radiological features suggest an alternate diagnosis.",
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AU - Jevremovic, Dragan

AU - Carlson, Matthew L.

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N2 - Objectives: To describe the clinical presentation, radiological features, and outcome of patients with plasmacytoma of the temporal bone. Methods: Multicenter retrospective case series of all patients diagnosed with plasmacytoma of the temporal bone between 1990 and 2015. Comprehensive literature review of all previously published cases. Results: A total of seven patients (average age, 57.3 yr; 57% women) met inclusion criteria. Three (43%) had a known history of multiple myeloma (MM). The most common symptoms at presentation included otalgia, headache, and dizziness (43%, each). Five (71%) presented with a vascular appearing middle ear mass visible on otoscopy. Four of these patients did not have an established history of MM and were referred with presumptive diagnoses of paraganglioma or endolymphatic sac tumor (ELST). The average maximum tumor diameter was 3.7 cm (median, 3.5 cm; range, 0.9-6.6 cm) and the most commonly involved temporal bone subsites were the middle ear and mastoid (71% each). MM was ultimately diagnosed in six cases (86%). In addition to the new cases presented herein, 18 previously published reports were analyzed. In the 25 aggregate cases, 44% of cases were associated with MM, and the mastoid (72%) and middle ear (53%) were the most commonly involved temporal bone subsites. Conclusion: Plasmacytoma of the temporal bone is rare, and the clinical presentation can closely mimic that of other primary temporal bone tumors. In patients with an established history of MM, it is imperative to have a high index of suspicion for temporal bone plasmacytoma, even when radiological features suggest an alternate diagnosis.

AB - Objectives: To describe the clinical presentation, radiological features, and outcome of patients with plasmacytoma of the temporal bone. Methods: Multicenter retrospective case series of all patients diagnosed with plasmacytoma of the temporal bone between 1990 and 2015. Comprehensive literature review of all previously published cases. Results: A total of seven patients (average age, 57.3 yr; 57% women) met inclusion criteria. Three (43%) had a known history of multiple myeloma (MM). The most common symptoms at presentation included otalgia, headache, and dizziness (43%, each). Five (71%) presented with a vascular appearing middle ear mass visible on otoscopy. Four of these patients did not have an established history of MM and were referred with presumptive diagnoses of paraganglioma or endolymphatic sac tumor (ELST). The average maximum tumor diameter was 3.7 cm (median, 3.5 cm; range, 0.9-6.6 cm) and the most commonly involved temporal bone subsites were the middle ear and mastoid (71% each). MM was ultimately diagnosed in six cases (86%). In addition to the new cases presented herein, 18 previously published reports were analyzed. In the 25 aggregate cases, 44% of cases were associated with MM, and the mastoid (72%) and middle ear (53%) were the most commonly involved temporal bone subsites. Conclusion: Plasmacytoma of the temporal bone is rare, and the clinical presentation can closely mimic that of other primary temporal bone tumors. In patients with an established history of MM, it is imperative to have a high index of suspicion for temporal bone plasmacytoma, even when radiological features suggest an alternate diagnosis.

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KW - Temporal bone malignancy

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