Case report and comprehensive literature review: A rare instance of solitary extramedullary plasmacytoma in the trachea

This case report describes a rare instance of isolated extramedullary plasmacytoma in the trachea of a 69-year-old female who presented with acute respiratory distress 1 h prior to admission. Chest computed tomography (CT) revealed a nodular lesion within the trachea, characterized by marginal calcification and severe stenosis of the tracheal lumen. Fiberoptic bronchoscopy demonstrated that the nodular lesion significantly obstructed the airway lumen. The patient underwent a technically demanding endoscopic tumor debulking procedure. Histopathological examination via endoscopic biopsy confirmed the diagnosis of plasmacytoma. Further diagnostic imaging, including positron emission tomography-computed tomography (PET-CT), showed abnormal fluorodeoxyglucose (FDG) uptake within the lesion. Bone marrow aspiration smear and biopsy excluded multiple myeloma. Postoperatively, the patient's symptoms markedly improved, and she was discharged on the day of surgery. One month after the procedure, follow-up chest CT and bronchoscopy indicated partial residual tumor without evidence of local recurrence. The patient reported significant improvement in respiratory function and subsequently received radiotherapy targeting the local lesion. Regular follow-up after radiotherapy confirmed no recurrence of the lesion. A literature review indicates that extramedullary plasmacytoma (EMP) is uncommon and predominantly affects the upper respiratory and digestive tracts. Diagnosis typically involves histopathological analysis, bronchoscopic evaluation, and advanced imaging techniques. Treatment strategies are tailored based on the patient's clinical presentation and tumor characteristics. This case underscores the importance of considering intratracheal plasmacytoma in the differential diagnosis of obstructive tracheal masses and highlights the critical role of timely endoscopic tumor debulking in relieving airway obstruction and facilitating subsequent treatment.