[Extramedullary plasmacytoma in the head and neck: a report of 10 cases and literature review]

Abstract

Background & objective: Extramedullary plasmacytoma (EMP), a rare tumor, often appears in the head and neck region. About 80% of EMPs occur in the submucosa of the upper aerodigestive tract. On both clinical presentation and pathologic examination, these tumors may be confused with some common tumors in the head and neck. This study was to evaluate clinical feature, diagnosis, and treatment of EMP in the head and neck.

Methods: Clinical data of 10 consecutive patients with pathologically confirmed EMP in the head and neck, treated in our hospital from Jan. 1977 to Dec. 2003, were reviewed. Of the 10 patients, 2 underwent surgery alone, 2 underwent surgery plus adjuvant radiotherapy,4 received radical radiotherapy, 1 received radical radiotherapy plus adjuvant chemotherapy, and 1 gave up treatment.

Results: The patients mainly manifested as local masses and relevant symptoms. Of the 3 patients received immunohistochemical staining to detect IgG, 1 was lambda type, and 2 were kappa type. Six patients received Bence-Jones protein detection, and 4 patients received serum myeloma protein detection; all of them showed negative results. Bone marrow biopsy was made in 4 patients, skeletal survey was made in 4 patients; all results were normal. By the end of follow-up (Mar. 2003), 6 patients were still alive (5 patients survived for more than 1 year, 3 of the 5 patients survived disease-freely for more than 15 years); 1 died of local recurrence 2 years after diagnosis; 1 died of multiple myeloma; 1 died of heart disease before treatment; 1 lost follow-up.

Conclusions: The diagnosis of EMP mainly depends on clinical manifestation and pathologic results. Radiotherapy and surgery are the main treatments for EMP in the head and neck.