IgD myeloma with multiple cutaneous plasmacytomas

Abstract

Extramedullary cutaneous plasmacytoma is an uncommon observation in clinical practice. In most of the cases it is usually an extension of underlying medullary plasmacytoma. This case report describes a patient with IgD myeloma who went into plateau phase following standard intravenous chemotherapy. After more than a year in plateau phase, he developed multiple fleshy nodular lesions in the skin. Biopsy of one of the lesions revealed relapse of myeloma in the skin. His IgD paraprotein remained in plateau phase and the bone marrow showed only 1% plasma cells. The patient has been treated with systemic intravenous chemotherapy followed by local radiotherapy.

The massive nodular cutaneous and soft tissues lesions of the right shoulder and the arm as the extramedullary manifestation of the advanced stage of multiple myeloma

“…These lesions were confined exclusively to the sites of the previous injections [9]. A few cases of extramedullary dissemination of plasma cells to the skin and the urinary bladder [10], to the pleura [11], and other examples of skin involvement [12][13][14] were described as the first manifestation of multiple myeloma. Currently modern therapeutic regimens based on agents that inhibit angiogenesis and proteasome inhibitors are used as a main treatment of multiple myeloma for many years.…”

Le myélome multiple à Ig D Kappa : une nouvelle observation

“…Ces localisations restent dominées par le plasmocytome extradural et les organomégalies (hépatomégalie, splénomégalie, adénopathies) [1,2,7]. D'autres localisations ont été rapportées, à savoir des plasmocytomes cutanés, des parties molles, du sein et méningé [2,[12][13][14]. Chez notre patient, les explorations n'ont pas mis en évidence de localisations extramé-dullaires.…”

Multiple cutaneous plasmacytomas following an autologous peripheral stem cell transplant

“…3,5 A few cases of cutaneous metastatic plasmacytomas have developed after chemotherapy for myeloma, and noncutaneous extra-medulary plasmacytomas following both allogeneic and autologous stem cell transplants. [6][7][8] To our knowledge, the cutaneous presentation of plasmacytomas after an autologous PBSC transplant is unreported.…”

“…10,11 In the presence of extensive involvement, often with underlying marrow involvement, chemotherapy in conjunction with radiotherapy remains the treatment of choice. 5,7,8 Adjuvant a-interferon has been tried as primary treatment 12 but also following relapsed myeloma after an autologous stem cell transplant. 9 It is important to recognize this unusual but rare development as a potential complication of autologous stem cell transplant.…”

“…Other treatments tried include intralesional steroid and tumour necrosis factor‐α 10,11 . In the presence of extensive involvement, often with underlying marrow involvement, chemotherapy in conjunction with radiotherapy remains the treatment of choice 5,7 , 8 . Adjuvant α‐interferon has been tried as primary treatment 12 but also following relapsed myeloma after an autologous stem cell transplant 9 …”