Solitary plasmacytoma (SP) is a tumor with evidence of clonal plasma cells and no other features of multiple myeloma
(MM). We report a case of SP which showed multiple recurrences of SP and then evolution into overt MM. A 56-year-old
man presented with the 5-month-history of right nasal obstruction and intermittent epistaxis. He had SP (extraosseous) of
right nasopharynx (3.5 × 2 × 2.5 cm), with no paraproteinaemia. He received radiotherapy (56 Gy), achieving complete
remission. Ten years later, he had recurrence of SP (osseous) in left tibia, presenting with pathological fracture. He
received radiotherapy (50 Gy), achieving partial response. Three years later, he had recurrence of SP (osseous) in right
tibia, presenting with right leg pain. He received radiotherapy (45 Gy). While receiving treatment, he had progressive
swelling in the area around right eye, double vision and headache. Imaging scans showed multiple plasmacytomas. There
were presence of monoclonal paraprotein, hypercalcemia and lytic bone lesions. He was diagnosed as MM (at the age
of 70 years) and treated with Bortezomib-based therapy. Currently, after one cycle of treatment, clinical improvement is
achieved. The importance of multi-disciplinary team approach for managing patients with plasmacytoma is highlighted
in order to achieve the holistic approach of management.