In conclusion, extramedullary plasmacytoma (EMPs) initially develop as localized disease. These tumors are quite sensitive to radiotherapy (RT) and the response is often complete recovery after RT. In addition, highly sensitive, conformal radiosurgery can be preferred to conventional RT; however, further studies are needed to define indications and therapeutic fractions in stereotactic RT of plasmacytoma since guidelines and clinical trials are lacking. Although general principles are valid, radiosurgery may be planned based on anatomical localization of EMP.