Abstract
Objective Extramedullary plasmacytomas are rare tumors. In the current study we aim to characterize
its clinical course at the skull base and define the most appropriate therapeutic
protocol.
Methods We conducted a meta-analysis of articles in the English language that included data
on the treatment and outcome of plasmacytoma of the base of skull.
Results The study cohort consisted of 47 patients. The tumor originated from the clivus and
sphenoclival region in 28 patients (59.5%), the nasopharynx in 10 patients (21.2%),
the petrous apex in 5 patients (10.6%), and the orbital roof in 4 patients (8.5%).
The chief complaints at presentation included recurrent epistaxis and cranial nerve
palsy, according to the site of tumor. Twenty-two patients (46.8%) had surgical treatment;
25 (53.2%) received radiation therapy. Adjuvant therapy was administered in 11 cases
(50%) with concurrent multiple myeloma.
The 2-year and 5-year overall survival rates were 78% and 59%, respectively. Clear
margin resection was achieved in a similar proportion of patients who underwent endoscopic
surgery and open surgery (p = 0.83). A multivariate analysis of outcome showed a similar survival rate of patients
treated surgically or with radiotherapy.
Conclusions The mainstay of treatment for plasmacytoma is based on radiation therapy, but when
total resection is feasible, endoscopic resection is a valid option.
Keywords
plasmacytoma - extramedullary - base of skull - clivus
