Locally recurrent extramedullary plasmacytoma of the upper aerodigestive tract.

Background: Extramedullary plasmacytomas (EMP) are plasma cell tumors in wh ich by definition the primary tumor is extramedullary. Most of them are fou nd in the upper aerodigestive tract. Patients: In this study we describe 3 patients with EMP. The first case is a locally recurrent EMP with recurrent involvement of cervical lymph nodes. The first manifestation of EMP was 31 years ago. Hence, this is one of the longest clinical courses of recurrent EMP ever described in the literature. Case Z is a locally aggressive recur rent EMP. Case 3 is a localized solitary EMP that could be successfully tre ated by surgery alone. Results and Conclusions: Different classifications o f EMP described in the literature are discussed. If these classifications a re applied to our cases neither the tumor stage nor the histological pictur e allow definite conclusions about the prognoses to be drawn. Metastases in regional lymph nodes do not necessarily mean a worse prognosis. Overall, c ompared to MM with a ten year survival rate of 18% the prognosis is more fa vorable in EMP with a ten year survival rate of 50%. After a generalized pl asma cell neoplasia has been excluded EMP in the head and neck should be tr eated like a locally aggressive and potentially metastatic tumor. From our experiences we recommend a primary surgical therapy followed by radiation t herapy if necessary.