Extramedullary plasmacytomas may be seen in the course of multiple myeloma. However, extramedullary progression despite good response in the bone marrow to therapy is extremely rare. Recently, two cases of multiple with extramedullary progression despite continued response to thalidomide in the bone marrow has been reported. In the present case, we did not use thalidomide for treatment of myeloma, moreover we observed extramedullary progression of the disease despite the continued marrow response and lack of the M-protein in serum or urine. Therefore, we think that not only thalidomide, but other chemotherapeutics also may change expression of adhesion molecules causing extramedullary progression of myeloma.