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Extramedullary plasmacytoma of the head and neck
1Department of Internal Medicine, Chang Gung Memorial Hospital, Taipai, Taiwan, R.O.C.
Abstract:
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.
Insights
Extramedullary plasmacytoma (EMP) of the head and neck is rare. Local irradiation is the recommended treatment of choice for EMP, with chemotherapy for advanced cases.
Area of Science:
- Oncology
- Pathology
Background:
- Extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm.
- It typically presents as a soft tissue mass in the head and neck region.
Purpose of the Study:
- To review the clinical characteristics and treatment outcomes of head and neck EMP.
- To establish optimal treatment strategies for this rare malignancy.
Main Methods:
- Retrospective review of 7 cases of head and neck EMP diagnosed between 1978 and 1992.
- Analysis of patient demographics, M-protein status, treatment modalities, and patient outcomes.
Main Results:
- All 7 patients were male, aged 27-66 years.
- M-protein was detected in 5 patients (IgG-kappa, IgG-lambda, Lambda light chain).
- Most patients received local irradiation; 3 received chemotherapy. All patients remained alive with long-term follow-up (37+ to 116+ months). One patient developed recurrence, and another developed multiple myeloma after refusing irradiation.
Conclusions:
- Local irradiation to primary sites and involved cervical nodes is the recommended treatment of choice for head and neck EMP.
- Chemotherapy may be considered for disease progression, recurrence, or dissemination.
- M-protein monitoring is valuable for assessing tumor control and disease progression.
