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.

The imaging findings of focal splenic, presacral and paraosseous EXTRAMEDULLARY hematopoiesis in a 35-year-old man with  b-thalassemia major are described with particular reference to ultrasonography and CT scan. A review of the radiological appearances of this rare condition is presented.

EXTRAMEDULLARY plasmacytoma (EMP) is a rare neoplasm of soft tissue which usually arises in the respiratory tract, nasal cavity, sinuses and nasopharynx.Multiple EXTRAMEDULLARY plasmacytomas are extremely rare, especially those that are not associated with multiple myeloma.We describe multiple primary EMP in a 37 year old man, without involvement of bone or bone marrow.EMP usually has a good prognosis but our patient survived only 15 months after diagnosis.

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.