A 72-year-old man with a history of nasal obstruction and swelling of the forehead area was referred to our department. CT revealed a mass in the right frontal sinus, extending into the ethmoid sinus and orbital fossa. Nasal biopsy showed sheets of plasma cell, and further investigation led to the diagnosis of IgG-type extramedullary plasmacytoma. Radiotherapy and an operation were performed and the tumor dissapeared. Since recurrence of the tumor was observed in the left maxillary sinus at 14 months after the initial treatment, we employed left partial maxillectomy in addition to radiation with intra-arterial chemotherapy. MCNU-VMD chemotherapy, consisting of MCNU, vincristine sulfate, melphalan and dexamethasone was performed when the tumor disseminated in the left humerus at four months after the second treatment.
In a case of advanced plasmacytoma the prognosis is often poor and chemotherapy should be used to achieve a better prognosis.
