Plasma cell neoplasms most commonly involve the bone marrow in a diffuse fashion (multiple myeloma), but they may also present as a localized lesion of bone (solitary plasmacytoma of bone) or soft tissues (extramedullary plasmacytoma [EMP]), or any combination thereof. Extramedullary plasmacytomas account for less than 1% of all head and neck neoplasms, with approximately 80% occurring in the head and neck. The most common site involved is the sinonasal region (44%); only 11% of EMPs involve the larynx (<100 cases have been reported).1 Most patients are men (male-female ratio, 3-4 to 1)2 older than 50 years.3