두경부 골수외 형질세포종의 임상적 고찰

Extramedullary Plasmacytoma of the Head and Neck

Objectives: This study was carried out to analyze the clinical profile and the results of treatment of a series of patients with extramedullary plasmacytoma(EMP) of the head and neck. Materials and Methods: The clinical features, treatment and survival of 14 patients with EMP seen at Yonsei Medical Center between 1970 and 1998 were carefully reviewed. Results: The median age was 48 years(range 15-75) and there was a male predominance(M:F 1.8:1). Nasal cavities and paranasal sinuses account for 50% of the primary sites and the most common symptom was airway obstruction(50%). Five patients(36%) showed evidence of adjacent bone destruction, one patient had lymph node involvement and one patient had an IgG monoclonal gammopathy at the time of diagnosis. All 5 patients treated with radiotherapy alone achieved local control. Of 5 patients treated with surgery alone, 2 patients(40%) had local failure. Of 3 patient treated with a combination of surgery and radiotherapy, one patient had local recurrence. A total of7 patients(54%) had local, distant or nodal relapses after primary treatment. Six of them received salvage treatment. With salvage treatment of surgery and/or radiotherapy, local control was achieved in 4 of 6 patients. Conversion to multiple myeloma was seen in one patient. Conclusion: Radiotherapy should be recommanded as treatment of choice for EMP of the head and neck. Surgery should be reserved for radioresistant or recurrent tumors, but tumors that are localized and can be removed relatively easily with little morbidity may be treated by primary surgery.