Solitary extramedullary plasmacytoma of the head and neck--long-term outcome analysis of 68 cases.

BACKGROUND

Head and neck solitary extramedullary plasmacytomas are rare plasma cell neoplasms. Literature review reveals only small numbers of reports. The objective was to review our experience with treating patients with this neoplasm.

METHODS

A retrospective chart review between 1960 and 2000 was performed. Sixty-eight patients with head and neck extramedullary plasmacytomas were included.

RESULTS

The sinonasal tract was the most common site. Thirty-nine patients were treated with radiation, 8 with surgery, 14 with surgery and radiation, and 3 with chemoradiation. Median follow-up was 8 years. The 5-year local recurrence-free rate (LRFR) was 81%. There was a trend toward improved LRFR in patients treated primarily with radiation. Regional recurrence at 5 years was 5%. Multiple myeloma developed in 23% of patients. The 5-year survival was 76%.

CONCLUSIONS

Radiation is the treatment of choice with surgery reserved for large tumors and extensive bone destruction. Long-term follow-up is essential because local recurrence and disseminated disease can occur many years postdiagnosis.