Management of Extramedullary Plasmacytomas

From 1965 through 1982. 12 patients with solitary, biopsy-proven extramedullary plasmacytomas (EMPs) were treated at our institution with surgery alone or biopsy followed by radiation therapy. The median age of the patients was 67 years, and the median-follow-up was 58 months. Of the seven patients who were treated by primary surgery, three developed recurrent or distant disease. Five patients underwent biopsy followed by radiation therapy, and none of their tumors progressed. Our series and a review of the literature show that occasionally EMPs will incompletely regress even after high doses of radiation (greater than 65 Gy); however, we recommend that doses of 45 to 50 Gy be used for most tumors, with greater doses being reserved for bulky or inaccessible tumors. Each tumor was classified histologically as well differentiated, moderately differentiated, or poorly differentiated. Patterns of pathology appear to be of no prognostic significance. Five patients (42%) were noted to have second neoplasms