CASEA 45-year-old man with a history of solitary plasmacytoma of the left hip, managed with surgery and radiation therapy 5 years back, was found to have new lytic lesions in his skull, discovered on an annual skeletal survey and confirmed by a head CT (Fig. 1). The patient had no major complaints, an unremarkable physical exam, and a mild anemia (Hemoglobin = 12 mg/dL). Due to concern for progression to multiple myeloma, the patient underwent a bone marrow biopsy, which revealed decreased hematopoiesis and 32 % myeloblasts, without evidence of a plasma cell dyscrasia (Fig. 2). Thus, a diagnosis of acute myeloid leukemia (AML) was made and induction chemotherapy was initiated.Secondary malignancies, including AML, can occur in patients with plasma cell disorders and a history of radiation or chemotherapy, and are associated with a worse prognosis. 1 More than half of patients with solitary plasmacytoma eventually develop multiple myeloma, despite therapy. 2 The bone lesions, anemia and history of plasmacytoma in this patient were suspicious for multiple myeloma; however, AML can also present with lytic bone lesions. 3 Bone marrow examination is essential in the evaluation of both multiple myeloma and AML.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.