Laryngeal plasmacytomas are rare plasma cell neoplasms that can mimic other lesions, posing a diagnostic and therapeutic challenge. Their location within the airway makes early diagnosis and precise management crucial to prevent airway compromise. This report aims to describe the first documented case of solitary laryngeal plasmacytoma managed with transoral microelectrode surgery (TOMES), highlighting its potential as a minimally invasive therapeutic option.

We describe a 60-year-old man with a laryngeal tumour initially misinterpreted. The tumor, located in the right ventricular band and extending to the ipsilateral vocal fold, was completely resected with TOMES. Histopathological examination confirmed the diagnosis of plasmacytoma, and systemic investigations ruled out multiple myeloma. The postoperative course was uneventful, with no recurrence after years of follow-up.

Although radiotherapy remains the standard treatment for solitary extramedullary plasmacytoma, complete transoral resection may be a valuable alternative, particularly when airway patency is threatened. TOMES provides precise cutting and excellent haemostatic control, enabling complete tumour excision with minimal morbidity and preservation of laryngeal function.

This is the first reported case of solitary laryngeal plasmacytoma successfully treated with TOMES. This minimally invasive technique represents a promising tool in the surgical management of laryngeal tumours.