Plasmacytoma of the Cervix Possibly Caused by Neglected Pessary: A Case Report and Literature Review

TL;DR

A rare case of cervical plasmacytoma possibly caused by a long-neglected pessary is reported, emphasizing the need for early diagnosis.

Contribution

This is a rare case report of cervical plasmacytoma potentially linked to chronic inflammation from a neglected pessary.

Findings

A 74-year-old woman had cervical plasmacytoma confirmed by biopsy and immunohistochemistry.

The case suggests a possible link between chronic pessary-induced inflammation and cervical plasmacytoma.

Early histopathological diagnosis is crucial for atypical cervical cases.

Abstract

Plasmacytoma is a rare plasma cell dyscrasia marked by localized monoclonal plasma cell proliferation, distinct from multiple myeloma by its lack of systemic symptoms. Extramedullary plasmacytoma (EMP), the rarest form, typically occurs in the upper respiratory tract. Cervical involvement is rare. Chronic inflammation may play a role in the development of cervical plasmacytoma, though this remains unproven for cervical cases.

We present a unique case of a 74-year-old woman who presented with vaginal bleeding linked to a neglected pessary inserted 15 years earlier. Upon examination, we discovered overgrown tissue with active bleeding. The biopsy revealed a monomorphic plasma cell infiltration, and immunohistochemistry confirmed CD138-positive, BCL2-negative cervical plasmacytoma, a rare occurrence in the cervix.

This case highlights the importance of considering cervical EMP in atypical cytology and suggests a possible link to chronic pessary-induced inflammation. Early diagnosis through histopathology and immunohistochemistry is essential.

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