Extramedullary plasmacytomas (EMP) of the nasopharynx are rarely associated with osseous destruction, and when destruction does occur, only minimal erosions have been found. More extensive bony involvement and intracranial extension in neoplasms of the head and neck usually suggest the presence of a more aggressive tumor such as carcinoma. We report computed tomographic (CT) findings in a nasopharyngeal EMP showing extensive intracranial involvement and severe bony destruction.