Transfacial excision of brainstem plasmacytoma.

Three distinct varieties of plasma cell tumors have been described: multiple myeloma (involvement of multiple osseous sites, bone marrow infiltration, and monoclonal gammopathy), plasmacytoma of bone (involving the spine or skull usually), and extramedullary plasmacytoma (EMP). EMPs, comprising only 3% of plasma cell neoplasms, are rare tumors with an annual incidence reported to be in the range of 3:100,000.1 Initially described by Schhridde in 1905, EMPs appear to represent an autonomous lymphoproliferative disease process whose natural history is distinct from that of solitary plasmacytomas of bone marrow. EMP may occur in any organ containing reticuloendothelial cells, with approximately 90% reported to occur in the head and neck region, most commonly in the upper respiratory tract (nose and paranasal sinuses).2 These tumors most commonly affect males (male/female ratio, 3:1) in the sixth and seventh decades. Although solitary plasmacytomas almost always eventually progress to multiple myeloma, this occurs infrequently with EMPs, which tend to be locally destructive. Dural EMP is exceedingly rare, with only 16 cases reported to date.3 To our knowledge, no cases of isolated dural EMP of the brainstem have been reported to date. In this brief article, we outline the presentation, treatment, and outcome of a patient with isolated dural brainstem EMP who presented to our institution. CASE REPORT