Two rare presentations of plasma cell neoplasm

A case of extramedullary plasmacytoma (EMP) in a 50year old woman and another case of solitary plasmacytoma of bone (SPB) with myeloma in a 34year old young man is reported. Atypical features of the SPB with myeloma patient were: a) age of the patient; b) lack of typical features of multiple myeloma (renal failure, hypercalcaemia and bone pain). The maxillary sinus was the site of the EMP who was referred for surgical excision. Biochemistry and haematological parameters were within normal range for both cases. Monoclonal paraprotein on serum electrophoresis was absent in EMP while it was present in SPB. Radiotherapy alone was given to the EMP patient while four courses of VAD (vincristine, adriamycine and dexamethasone) chemotherapy in addition to radiotherapy was given to the SPB with myeloma patient. Although EMP and SPB are both localized forms of plasma cell dyscrasias, SPB seems to have a greater tendency to multiple myeloma.