Extraosseous myeloma of liver mimicking multifocal hepatocellular carcinoma where a distinction has to be made: two case reports

Kwok, Hoi Ming; Lo, Eugene Sean; Wong, T; Lee, Heather HC; Chau, HT; Ng, FH; Luk, WH; Kf, Johnny

doi:10.12809/hkmj219640

Cited by 2 publications

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A rare nodular lesion of the liver with MM was evidenced by nine (0.35%) cases of macroscopic imaging among 2,584 patients [18]. Kwok et al described two cases of secondary MM involvement of the liver, in which bilobar hypo-and hyperechoic lesions (the latter occasionally with hypoechoic rims) were detected [19], resembling the sonographic pattern presented in our case report. Therefore, the visual radiologic features of hepatic MM involvement are not clearly specific and may differ, posing a challenge in distinguishing it from other liver lesions, especially in cases with an atypical clinical presentation.…”

Section: Discussionsupporting

confidence: 81%

Multiple Myeloma Patient with Secondary Liver and Tongue Involvement, Complicated by COVID-19-Induced ARDS: An Autopsy Case Report and Literature Review

Matskevych,

Ilnytska,

Lenchuk

et al. 2024

Galician med. j.

View full text Add to dashboard Cite

Background. Liver involvement secondary to multiple myeloma is a rare and uncommon radiologic finding. Such extraosseous secondary lesions as well as tongue involvement require pathohistological confirmation to prevent misdiagnosis. Clinical and laboratory diagnostics are challenging in patients with COVID-19 and underlying multiple myeloma and its secondary lesions, leading to difficulties in treatment and outcomes. Case Report. A 64-year-old male patient, not vaccinated against COVID-19, with a history of multiple myeloma presented with symptoms of headache, fatigue, dyspnea, cough, and fever. The patient’s medical history was intricate, involving cholecystectomy and a diagnosis of multiple myeloma, which was subsequently treated with chemotherapy and radiation therapy. Additionally, uncommon liver and tongue involvement secondary to multiple myeloma was found. Upon admission, the patient’s peripheral oxygen saturation was 90%, accompanied by increasing shortness of breath and a respiratory rate of 26 breaths per minute. A positive COVID-19 test was recorded. A lung computed tomography revealed bilateral multifocal areas of ground-glass opacity and consolidation, encompassing the entire pulmonary regions, corresponding to CO-RADS 6. The patient was admitted to the intensive care unit. Despite initiating oxygen support and symptomatic therapy, the patient’s death occurred. Autopsy confirmed the development of severe acute respiratory distress syndrome and bilateral hemorrhagic pneumonia, with multiple myeloma as a contributing factor. Conclusions. This case report highlighted the rare occurrence of secondary liver involvement in multiple myeloma, characterized by nodules with distinct imaging features. It underscored the importance of identifying coexisting lesions, such as tongue involvement, and the diagnostic challenges they pose. Additionally, the case emphasized the need for comprehensive clinical assessment in patients with concurrent COVID-19 and underlying multiple myeloma, as it may lead to the development of acute respiratory distress syndrome.

show abstract

Section: Discussionsupporting

confidence: 81%