Article Text
Summary
Plasma cell mucositis (PCM) is a rare non-neoplastic plasma cell proliferative disorder of the mucous membranes, which typically presents as soft tissue lesions involving oral, upper airway or genital mucosa. Laryngeal involvement resulting in stridor has been reported in four other cases previously, with three requiring tracheostomy. We present a case of supraglottic stenosis in a 53-year-old woman presenting with dysphonia and stridor, requiring surgical resection on three occasions accompanied by tracheostomy on two occasions; biopsy was consistent with PCM. Due to relapsing disease activity, high-dose prednisolone and mycophenolate mofetil were commenced with prednisolone eventually being ceased. After 2 years of mycophenolate mofetil therapy, the patient’s disease has been controlled without need for further surgical intervention. This is the first reported case of prolonged symptomatic improvement with the use of systemic immunosuppressive therapy with mycophenolate mofetil in PCM.
- ear, nose and throat
- malignant disease and immunosuppression
- ear, nose and throat/otolaryngology
- immunology
- head and neck surgery
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Footnotes
Contributors JT: responsible for identification of case, manuscript authorship and literature review. GH: responsible for identification of case and manuscript review. AM-T: responsible for manuscript review. ML: responsible for case identification, manuscript authorship and manuscript review. No financial support or funding was involved in the publication of this paper.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
Author note Immunotherapy-induced remission of laryngeal Plasma Cell Mucositis James Triplett1, Geoffrey Hee2, Andrew McLean-Tooke1, Michaela Lucas1, 3,4,5
1 Department of Immunology, PathWest, Laboratory Medicine, QE II Medical Centre, Perth, Australia.
2 Department of Surgery, Sir Charles Gairdner Hopsital, Perth, Australia Medicine, QE II Medical Centre, Perth, Australia.
3 School of Medicine and Pharmacology, University of Western Australia, Australia. 4 School of Pathology and Laboratory Medicine, University of Western Australia, Australia. 5 Institute for Immunology and Infectious Diseases, Murdoch University, Australia.