J Neurol Surg B Skull Base 2016; 77(01): 061-065
DOI: 10.1055/s-0035-1560047
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Plasmacytoma of the Skull Base: A Meta-Analysis

Shorook Na'ara
1   Department of Otolaryngology, Head and Neck Surgery, The Head and Neck Center, Rambam Medical Campus, Haifa, Israel
2   The Laboratory for Applied Cancer Research, CRIR, Rambam Medical Campus, Haifa, Israel
,
Moran Amit
1   Department of Otolaryngology, Head and Neck Surgery, The Head and Neck Center, Rambam Medical Campus, Haifa, Israel
2   The Laboratory for Applied Cancer Research, CRIR, Rambam Medical Campus, Haifa, Israel
,
Ziv Gil
1   Department of Otolaryngology, Head and Neck Surgery, The Head and Neck Center, Rambam Medical Campus, Haifa, Israel
2   The Laboratory for Applied Cancer Research, CRIR, Rambam Medical Campus, Haifa, Israel
,
Salem Billan
3   Oncology Department, Rambam Medical Campus, Haifa, Israel
› Author Affiliations
Further Information

Publication History

12 May 2015

25 June 2015

Publication Date:
20 August 2015 (online)

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.