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CASE 4

CASE 4 . 39 yr-old man HIV + 1999 Asymptomatic CD4 810 HIV viral load <40 ABC/3TC/ Nevirapine Subzygomatic Bioalcamid facial implants. CASE 4 . Right sided nasal/sinus fullness/pressure over 6 months…just doesn ’ t feel right

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CASE 4

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  1. CASE 4 • 39 yr-old man • HIV + 1999 • Asymptomatic • CD4 810 HIV viral load <40 • ABC/3TC/Nevirapine • SubzygomaticBioalcamidfacial implants

  2. CASE 4 • Right sided nasal/sinus fullness/pressure over 6 months…just doesn’t feel right • No improvement with nasal steroid spray/trial of antibiotics

  3. CASE 4 • CT scan unremarkable for nasal/sinus lesions or signs of subclinical infection/inflammation of rtsubzygomaticBioalcamid

  4. CASE 4 • 1 month later with no improvement of non specific rt nasal/sinus fullness/pressure seen by ENT physician • Scoped and a small area of nasal septalsoft tissue noted to look different than surrounding area

  5. CASE 4 • Biopsy of this abnormal area revealed plasma cell infiltration…found to be monotypic and compatible with a solitary extraosseusplasmacytoma • Serum/urine immunoelectrophoresis, skeletal survey and bone marrow biopsy negative for myeloma

  6. CASE 4 • Treated with multiple courses of radiotherapy • Now symptom free • Followed for recurrence of plasmacytoma/development of myeloma

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