Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13364
Peer-review started: August 16, 2022
First decision: September 5, 2022
Revised: September 17, 2022
Accepted: December 5, 2022
Article in press: December 5, 2022
Published online: December 26, 2022
Processing time: 132 Days and 15.9 Hours
Solitary plasmacytoma and unicentric Castleman disease (UCD) are rare lymphoproliferative disorders characterized by monoclonal plasma cells and a single set of locally enlarged lymph nodes, respectively.
A 48-year-old Han Chinese man presented to our department with a neck mass and progressive foreign body sensation in his throat. 18F-FDG positron emission tomography revealed focally increased radioactivity centered around the hyoid, and computed tomography (CT) revealed osteolytic lesions. Histopathology revealed Castleman-like features and CD138/CD38-positive mature plasma cells. Systemic work-up ruled out the possibility of POEMS syndrome, lymphoma, and multiple myeloma, leading to a final diagnosis of solitary hyoid plasmacytoma with UCD. The patient underwent partial hyoid resection and selective neck dissection, followed by intensity-modulated radiotherapy. 99mTc-MDP single-photon emission computed tomography/CT reevaluation showed neither local recurrence nor distant bone metastasis at the 40-mo follow-up.
The diagnostic process and differential diagnosis of this rare case provided valuable educational information to clinicians.
Core Tip: In this study, we described the clinical presentations, diagnosis and differential diagnosis, management, outcome, and relative long-term follow-up for a man simultaneously affected with solitary plasmacytoma (SP) of the hyoid bone and unicentric Castleman disease. To our knowledge, this is the first reported case presented with these two rare clinical entities. Besides the comprehensive histopathological examination, 18F-FDG positron emission tomography/computed tomography (CT) and 99mTc-MDP single-photon emission computed tomography (SPECT)/CT were broadly used in our clinical practice of differential diagnosis, disease staging, and follow-up monitoring, highlighting the advantages of nuclear medicine and other imaging techniques in the management of SP in the head and neck. Additionally, the diagnostic process and differential diagnosis of this patient provided valuable educational information to clinicians.