Extramedullary plasmacytoma of the head and neck.

Extramedullary plasmacytoma (EMP) is an uncommon malignant plasma cell neoplasm which usually presents as soft tissue mass in the head and neck. We retrospectively reviewed 7 cases with EMP of the head and neck between 1978 and 1992. All patients were male. Their ages ranged from 27 to 66 years. M-protein was identified in 5 patients (IgG-kappa in 3, IgG-lambda in 1 and Lambda light chain in 1). All but one were treated with local irradiation. Three patients received chemotherapy. All patients have been alive for 37+ to 116+ months since the diagnosis of EMP. One patient had a cervical node recurrence 9 years after local irradiation and the other one who refused local irradiation but received chemotherapy developed multiple myeloma 5 years later. Based on our experience and the review of the literature, it is recommended that irradiation to the primary sites and the involved cervical nodes is the treatment of choice. Additional chemotherapy may be considered in patients with disease progression, recurrence, or dissemination. The M-protein is a useful parameter to assess tumor control or disease progression.