EXTRAMEDULLARY PLASMACYTOMAs are plasma cell tumors that arise outside the bone marrow. They are most often located in the head and neck. EXTRAMEDULLARY PLASMACYTOMAs account for approximately 3 percent of plasma cell malignancies. The diagnosis of an EXTRAMEDULLARY PLASMACYTOMA depends upon the demonstration of a monoclonal plasma cell tumor at an EXTRAMEDULLARY site with no evidence of multiple myeloma based upon bone marrow examination and roentgenographic studies, absence of an M- protein in serum and/ or urine, and no related organ or tissue impairment. These tumors are highly responsive to local radiation therapy and rarely progress or recur. A 77 year old man referred for gradual enlargement of scrotum in April, 2004. He had no fever, weight loss or loss of appetite during the period. No tenderness, warmth or erythem of scrotum was observed on physical examination. No lymphadenopathy was detected. Later he had temporary relief because of antibiotic therapy. 7 months later, he referred again following the aggravation of his symptom. Ultrasonography of his scrotum was done and enlargement in the left testis was reported. Lab data including CBC, diff, ESR, AFP were normal but βHCG titer was reported higher than normal. He underwent radical orchiectomy and the specimen was sent for pathological study. Spermatocytic seminoma and PLASMACYTOMA were suspected, but PLASMACYTOMA was reported after the IHC. In order to rule out multiple myeloma, whole body bone scanning with sestamibi and urine Bence Jones protein were examined, all of which were negative. In bone marrow aspiration, the cellularity was normal and no pathologic lesion was reported. Considering clinical and paraclinical evidences, the diagnosis was EXTRAMEDULLARY PLASMACYTOMA.

EXTRAMEDULLARY PLASMACYTOMA is defined as neoplastic proliferation of plasma cells in soft tissue. It accounts for up to 3% of all plasma cell tumors. Approximately, 90% of EXTRAMEDULLARY PLASMACYTOMAs are found in the head and neck region commonly affecting the nasal cavity, paranasal sinuses, tonsillar fossa, and oral cavity. Radiotherapy is the common modality of treatment with or without adjuvant chemotherapy. We report a case of EXTRAMEDULLARY PLASMACYTOMA of the gingiva.

Introduction: Solitary PLASMACYTOMA is an uncommon type of plasma cell dyscrasia, which might occur in bone or soft tissue. Soft tissue solitary PLASMACYTOMA or EXTRAMEDULLARY PLASMACYTOMA is less frequent than bone PLASMACYTOMA. The most common location for extramedulary PLASMACYTOMA is nasopharynx and paranasal sinuses. Case Presentation: Oropharyngeal PLASMACYTOMA is very rare; hence we would like to share our experience. The patient was a 57 year-old man with 2 months history of dysphagia with a foreign body sensation. Total tumor resection was done and he received 40 Gy radiation. After 24 months of follow up the patient was well and disease free. Conclusion: according to the presented case, a PLASMACYTOMA should be considered in patients with dysphagia and oropharyngeal lesion. These masses can be treated with surgical excision and radiotherapy.

Background: The incidence of PLASMACYTOMA in age group over 25 years is 30 per 100.000.PLASMACYTOMA presents in three clinical patterns: 1- MultipleMyeloma (MM) 2-SolitaryPLASMACYTOMA of bone 3-EXTRAMEDULLARY PLASMACYTOMA (EMP). One hundred eleven cases of laryngeal PLASMACYTOMA had been reported to 1995. Twenty one cases of these patients were metastases of multiple myeloma. Radiotherapyis treatment of choice and in some cases surgery and adjuvant chemotherapy is added.Case: We report a 57 years old woman with multiple myeloma. She was treated by chemotherapy but she raftered with hoarseness and respiratory distress. EXTRAMEDULLARY PLASMACYTOMA was diagnosed in our clinical examination and laryngeal biopsy. The mass disappeared completely with radiotherapy.Conclusion: Chemotherapy in multiple myeloma doesn't prevent of laryngeal metastasis definitively and still the treatment of choice for EMP is 4000 CGY radiotherapy.

The Patient is a 58 years old woman who admitted in Hazrat-Rasoul Akram Hospital because of enlargement of anterior of neck and signs of upper respiratory tract obstruction. By X-Ray, sonography and C-T scanning, a mass in pararetropharyngeal region (4.5×10 cm) was detected. After FNA and biopsy, PLASMACYTOMA was suggested which confirmed by immunohistochemical staining. This uncommon case should be controlled and even cured by proper diagnosis and radiotherapy.

Extra medullary PLASMACYTOMAs are rare solitary soft tissue tumors that arise from proliferations of malignant transformed monoclonal plasma cells and can be diagnosed through biopsy and histopathologic examination. These lesions are closely associated with multiple myelomas, which should be ruled out in all these cases by necessary laboratory and radiographic examinations. A 25-year-old man was referred to our clinic with a rapidly-growing painless lesion measuring about 2.5×3×3 cm in the palatal side of the left maxillary second and third molar teeth. A diagnosis of solitary PLASMACYTOMA was made on the basis of clinical, radiographic, and histopathological findings. Early diagnosis of EXTRAMEDULLARY PLASMACYTOMAs is of great importance.Radiotherapy is the common modality of treatment with or without adjuvant chemotherapy.Progression to multiple myeloma is possible; thus, close follow-up of the patient is essential after completion of the therapeutic procedure.

Breast PLASMACYTOMA is a rare neoplasm. Here we present a case of EXTRAMEDULLARY PLASMACYTOMA of the breast in a 41-year-old Iranian lady who was a known case of spine PLASMACYTOMA. Two years ago study case was presented with severe back pain. At that time, MRI revealed an expansile and destructive lesion in the body of S1 which was suggestive of metastasis. The patient underwent incisional biopsy that was a representative of a PLASMACYTOMA. Skeletal survey, bone marrow aspiration, and serum protein electrophoresis were negative. The patient received radiation therapy. This year (2 years later) she detected a mass in her right breast. A mammography revealed a 30 mm high-density mass with an ill-defined border in the right breast. The mass was excised, and histological examination confirmed the diagnosis of PLASMACYTOMA. Although PLASMACYTOMA of the breast is rare, this tumor should be considered as a differential diagnosis of a breast mass, especially in patients with plasma cell dyscrasias.