Skull Base 2002; 12(2): 077-086
DOI: 10.1055/s-2002-31570
CASE REPORT

Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Plasma Cell Tumors of the Skull Base: Four Case Reports and Literature Review

Richard O. Wein, Saurin R. Popat, Timothy D. Doerr, Paul O. Dutcher
  • University of Rochester Medical Center, Division of Otolaryngology, Rochester, New York
Further Information

Publication History

Publication Date:
18 May 2004 (online)

ABSTRACT

Four patients (mean age, 46 years; range, 28 to 60) with skull base plasmacytomas are presented along with a review of the literature examining the progression of anterior and central skull base plasma cell tumors to multiple myeloma. The primary sites were the nasopharynx, orbital roof, sphenoid, and clivus. Three patients presented with extensive local spread of tumor. Two patients were diagnosed with multiple myeloma and treated with chemotherapy. Patients with an isolated plasmacytoma were treated with external beam radiation. A partial or complete response to therapy was seen in all four cases. Skull base plasma cell tumors are uncommon with only a limited number of published reports. Previous literature demonstrates that nasopharyngeal extramedullary plasmacytomas have a lower rate of progression to multiple myeloma than other sites. Patients with clivus, sphenoid, and petrous apex-based plasma cell tumors appear to have a higher risk of developing multiple myeloma than patients with plasma cell tumors involving the nasopharynx.

REFERENCES

  • 1 Dimopoulas M A, Kiamouris C, Moulopoulos L A. Solitary plasmacytoma of bone and extramedullary plasmacytoma.  Hematol Oncol Clin North Am . 1999;  13 1249-1257
  • 2 Wax M K, Yun K J, Omar R A. Extramedullary plasmacytomas of the head and neck.  Otolaryngol Head Neck Surg . 1993;  109 877-885
  • 3 Miller F R, Lavertu P, Wanamaker J R. Plasmacytomas of the head and neck.  Otolaryngol Head Neck Surg . 1998;  119 614-618
  • 4 Bartl R, Frisch B, Fateh-Moghadam A. Histologic classification and staging of multiple myeloma: a retrospective and prospective study of 674 cases.  Am J Clin Path . 1987;  87 342-355
  • 5 Susnerwala S S, Shanks J H, Scarffe J H. Extramedullary plasmacytoma of the head and neck region: clinicopathological correlation in 25 cases.  Br J Cancer . 1997;  75 921-927
  • 6 Clarke E. Cranial and intracranial myelomas.  Brain . 1954;  77 61-72
  • 7 Alegre A, Tomas J F, Pinilla I. Multiple myeloma presenting as plasmacytoma of the base of the skull [letter].  Am J Hematol . 1996;  52 60-61
  • 8 Alexiou C, Kau R J, Dietzfelbinger H. Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts.  Cancer . 1999;  85 2305-2314
  • 9 Bindal A K, Bindal R K, van Loveren H, Sawaya R. Management of intracranial plasmacytoma.  J Neurosurg . 1995;  83 218-221
  • 10 Nofsinger Y C, Mirza N, Rowan P T. Head and neck manifestations of plasma cell neoplasms.  Laryngoscope . 1997;  107 741-746
  • 11 Nikolidakis A A, Skoulakis C E, Papadakis C E. Solitary extramedullary plasmacytoma of the nasopharynx.  J Otolaryngol . 2000;  29 254-257
  • 12 Hotz M A, Schwaab G, Bosq J, Munck J N. Extramedullary solitary plasmacytoma of the head and neck: a clinicopathological study.  Ann Otol Rhinol Laryngol . 1999;  108 495-500
  • 13 Sulzner S E, Amdur R J, Weider D J. Extramedullary plasmacytoma of the head and neck.  Am J Otolaryngol . 1998;  19 203-208
  • 14 Corsetti R L, Ready N E, Wanebo H J. Cryotherapy for a plasmacytoma of the nasopharynx: a newer approach to a difficult surgical access site.  Surg Rounds . 2000;  December 707-712
  • 15 Toland J, Phelps P D. Plasmacytoma of the skull base.  Clin Radiol . 1971;  22 93-96
  • 16 Marais J, Brookes G B, Lee C C. Solitary plasmacytoma of the skull base.  Ann Otol Laryngol . 1992;  101 665-668
  • 17 Sully R E, Mark E J, McNeely W F, McNeely B U. Case records of the Massachusetts General Hospital: weekly clinicopathological exercises. Case 21-1992.  New Engl J Med . 1992;  326 1417-1724
  • 18 Vijaya-Sekaran S, Delap T, Abramovich S. Solitary plasmacytoma of the skull base presenting with unilateral sensorineural hearing loss.  J Laryngol Otol . 1999;  113 164-166
  • 19 Rosai J. Ackerman's Surgical Pathology.  8th ed. St. Louis: Mosby-Year Book, Inc 1996: 1880
  • 20 Mewis-Levin L, Garcia C, Olson S. Plamsa cell myeloma of the orbit.  Ann Ophthalmol . 1981;  17 477-481
  • 21 Erza E, Mannor G, Wright J E, Rose G E. Inadequately irradiated solitary extramedullary plasmacytoma of the orbit requiring exenteration.  Am J Ophthalmol . 1995;  120 803-805
  • 22 Kapadia S B, Desai U, Cheng V S. Extramedullary plasmacytoma of the head and neck.  Medicine . 1982;  61 317-329