Extramedullary myeloma representing as a pericardial effusion with tamponade: Two case reports and a further review of 19 cases in the literature

Abelman, W; Virchis, Andres; Yong, Kwee

doi:10.1080/10428190400011583

Cited by 15 publications

(17 citation statements)

References 12 publications

(12 reference statements)

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“…However, patients with pleuropericardial effusions are usually resistant to treatment and often relapse in spite of aggressive chemotherapy . Median time to death from diagnosis of pericardial involvement is 13 weeks and patients die mainly from progressive disease (92%) and/or related sepsis . Our patient was treated with pericardiocentesis, thoracocentesis, and a combination of carfilzomib and dexamethasone achieving a quick and sustained complete response, with excellent tolerance.…”

Section: Discussionmentioning

confidence: 91%

“…The latter has a shorter overall survival. Pericardial or pleural myelomatous effusions as extramedullary disease involvements are extremely rare . Abelman et al.…”

Section: Discussionmentioning

confidence: 99%

“…Pericardial or pleural myelomatous effusions as extramedullary disease involvements are extremely rare [2,3]. Abelman et al [2] reviewed pericardial myelomatous disease revealing a median age at presentation of 67 years, with IgG isotype predominance; 67% of cases were relapsed myeloma patients, cardiac tamponade was present in 63%, and pleural involvement was seen in 19% of these patients. Prognosis was poor with progression or disease recurrence after 3 months in 65% patients.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Carfilzomib and dexamethasone for extramedullary myeloma with pleuropericardial involvement

Español

Romera

Gutiérrez-Meca

et al. 2017

Clinical Case Reports

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Section: Discussionmentioning

confidence: 91%

“…The latter has a shorter overall survival. Pericardial or pleural myelomatous effusions as extramedullary disease involvements are extremely rare . Abelman et al.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Carfilzomib and dexamethasone for extramedullary myeloma with pleuropericardial involvement

Español

Romera

Gutiérrez-Meca

et al. 2017

Clinical Case Reports

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“…A 2005 case review by Abelman, Virchis and Yong discusses 22 instances where extramedullary relapse of myeloma involved the pericardium. 7 Multiple myeloma subtype and genetics were highly variable, as were the treatment regimens which involved a combination of systemic therapy, stem cell transplant, intrapericardial chemotherapy and radiation. Median survival after relapse was 13.5 weeks.…”

Section: Learning Pointsmentioning

confidence: 99%

Pericardial relapse of multiple myeloma

Jamison

Kwok

2020

BMJ Case Rep

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In patients who experience relapse of multiple myeloma, upwards of 30% can have extramedullary disease. The presence of extramedullary multiple myeloma is typically associated with adverse cytogenetics and a poor prognosis. Organs most commonly involved include the liver, skin, central nervous system, pleural effusions, kidney, lymph nodes, and pancreas. We present the case of a 53-year-old man with IgA kappa multiple myeloma with the adverse cytogenetic findings of t(4;14) and 1q21 gain who had achieved a stringent complete (sCR) response after initial therapy with carfilzomib, lenalidomide and dexamethasone. Stringent complete response is defined as the normalization of the free light chain ratio in the serum and an absence of clonal cells in the bone marrow in additiion to criteria needed to achieve complete response. Prior to undergoing a planned autologous stem cell transplant, this patient experienced cardiac tamponade secondary to extramedullary relapse of his multiple myeloma which was limited to the pericardium. In response, his treatment regimen was transitioned to pomalidomide, bortezomib, dexamethasone and cyclophosphamide for three cycles after which he again achieved sCR and ultimately underwent autologous stem cell transplant. Post-transplant consolidation therapy was administered in the form of pomalidomide, bortezomib and dexamethasone, followed by pomalidomide and bortezomib maintenance, which he has continued to receive for 3 years without evidence of disease progression.

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“…It may occur in all lymph nodes, skin, liver and spleen, and less frequently in the kidney and dura mater [1,6]. More rarely, involvements of the orbita, muscle, skin, and pericardium are seen [7][8][9]. Diagnosis is made with the establishment of monoclonal plasma cells in the involved organ.…”

Section: Introductionmentioning

confidence: 99%

A rare extramedullary involvement in myeloma: lung parenchyma and association with unfavorable chromosomal abnormalities

Balçık¹,

Albayrak²,

Dağdaş³

et al. 2010

Turk J Hematol

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Although pulmonary complications developing secondary to lung infections and involvement in ribs occur frequently in multiple myeloma (MM), involvement of the lung parenchyma is quite rare. In clinical studies, the involvement of lung parenchyma has been found to be associated with unfavorable prognosis. Here, a MM case in whom involvement of lung parenchyma was accompanied by unfavorable prognostic cytogenetic markers is presented. A 62-year-old male presented with complaint of cough, and heterogeneous hypodense mass was detected in thorax computerized tomography. The patient underwent bronchoscopic biopsy. Pathological examination revealed diffuse plasma cell infiltration staining with kappa immunohistochemically. In bone marrow biopsy, plasma cell infiltration was observed. In conventional cytogenetic examination, hypodiploidy was established. In cytogenetic examination carried out with fluorescence in situ hybridization, deletion (13q) was determined. In conclusion, in patients diagnosed with MM and presenting with pulmonary mass lesion, lung involvement associated with plasma cell infiltration should also be considered in the differential diagnosis. As overall survival is low in these cases, more aggressive treatment approaches such as high-dose treatment should be immediately considered. (Turk J Hematol 2010; 27: 109-12) Key words: Myeloma, pulmonary involvement, prognostication, cytogenetics, molecular genetics, del(13q), hypodiploidy Received: May 7, 2008 Accepted: January 7 2009 ÖzetMultipl miyelomda (MM) akciğer enfeksiyonları ve göğüs kafesi kemiklerinde tutuluma bağlı gelişen pulmoner komplikasyonlar sıkça görülmesine karşın, akciğer parankim tutulumu oldukça nadirdir. Yapılan klinik çalışmalarda akciğer parankim tutulumunun kötü prognoz ile ilişkisi bulunmuştur. Burada akciğer parankim tutulumuna olumsuz prognostik sitogenetik belirleyicilerin eşlik ettiği bir MM olgusu sunulmaktadır.

show abstract

Extramedullary myeloma representing as a pericardial effusion with tamponade: Two case reports and a further review of 19 cases in the literature

Cited by 15 publications

References 12 publications

Carfilzomib and dexamethasone for extramedullary myeloma with pleuropericardial involvement

Carfilzomib and dexamethasone for extramedullary myeloma with pleuropericardial involvement

Pericardial relapse of multiple myeloma

A rare extramedullary involvement in myeloma: lung parenchyma and association with unfavorable chromosomal abnormalities

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