Sinonasal extramedullary plasmacytoma: a systematic review of 175 patients

Int Forum Allergy Rhinol. 2014 Feb;4(2):156-63. doi: 10.1002/alr.21254. Epub 2013 Dec 13.

Abstract

Background: This study reviews the published literature related to extramedullary sinonasal plasmacytomas. Clinical presentation, demographics, treatment, and outcomes of this uncommon disease are reported.

Methods: A systematic review of studies for sinonasal plasmacytomas from 1950 to 2012 was conducted. A PubMed database search, both for articles related to this condition along with bibliographies of those selected articles, was performed. Articles were examined for patient data that reported disease outcome.

Results: Sixty-seven journal articles were included in this analysis, comprising a total of 175 cases. Radiotherapy was the most common treatment modality, used in 89 cases, followed by a combination of surgery and radiotherapy, and surgery alone. A total of 71.8% of patients were alive after a median follow-up of 39 months, independent of treatment modality. A combination of radiotherapy and chemotherapy was rarely used but had the best treatment outcome, with 88.9% of patients (8/9 patients) alive. Of the 3 most common treatment modalities, a combination of radiotherapy and surgery had the most favorable outcomes. Sixteen patients (9.1%) converted to multiple myeloma, with the majority of these patients (75.0%) receiving radiotherapy alone as their treatment modality.

Conclusion: This review contains the largest pool of sinonasal plasmacytoma patients to date and suggests aggressive radiotherapy is the most common treatment modality for this condition. Of the 3 most common treatment modalities, a combination of surgery and radiotherapy was shown to have the best survival outcomes.

Keywords: chemotherapy; extramedullary plasmacytoma; nasal tumor; plasmacytoma; radiotherapy; sinonasal plasmacytoma; sinus tumor; surgical management.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Combined Modality Therapy
  • Humans
  • Nose Neoplasms / mortality
  • Nose Neoplasms / radiotherapy*
  • Nose Neoplasms / surgery
  • Paranasal Sinuses / pathology*
  • Paranasal Sinuses / radiation effects
  • Paranasal Sinuses / surgery
  • Plasmacytoma / mortality
  • Plasmacytoma / radiotherapy*
  • Plasmacytoma / surgery
  • Survival Analysis
  • Treatment Outcome