Late relapse of multiple myeloma presenting as a right atrial mass

Abstract

Intracardiac involvement is a rare presentation of relapsed multiple myeloma. We present a case of lobulated mass in the wall of the right atrium, with extension to the inferior vena cava and obliteration and encasement of the interatrial septum in a 57-year-old man, a known case of multiple myeloma, with progressive exertional dyspnea and anasarca.

Multiple myeloma with cardiac involvement accompanied by partial superior vena cava obstruction: A case report and literature review

“…16 There is no clear 1), including surgical resection. 9 In our patient, surgical resection was used to remove a large part of the space-occupying mass, and superior vena cava venoplasty was performed. Short-term follow-up showed that the symptoms of obstruction completely disappeared and TEE showed no signs of recurrence.…”

“…We searched for cases of MM with cardiac solid space-occupying lesions reported in the last 10 years on PubMed and only found 11 other cases. [3][4][5][6][7][8][9][10][11] We used a table to list the sex, age, symptoms, disease course, imaging method used for mass diagnosis, site and size of mass, treatment method, and outcome of these patients (including the current case) (Table 1). These 12 patients comprised eight males (67%) and four females (33%), with a mean age of 64. and spread along the endocardium to surrounding tissues; this leads to embolism or obstruction and corresponding clinical symptoms.…”

“…Extramedullary cardiac involvement is rare and mainly presents as pericardial effusion, while endocardial involvement is extremely rare, with very few cases reported so far. We searched for cases of MM with cardiac solid space‐occupying lesions reported in the last 10 years on PubMed and only found 11 other cases 3–11 . We used a table to list the sex, age, symptoms, disease course, imaging method used for mass diagnosis, site and size of mass, treatment method, and outcome of these patients (including the current case) (Table 1).…”

Extramedullary intracardiac multiple myeloma misdiagnosed as a thrombus: a case report

“…The clinical symptoms of extramedullary intracardiac MM are nonspecific, depending on the localization and size of the mass. Patients might present with pericardial tamponade, arrhythmia, SVC syndrome, or severe heart failure [ 5 , 10 ]. In this case, the large right atrial mass resulted in symptoms of SVC obstruction and right heart dysfunction in the patient.…”

“…Surgical intervention is usually palliative because the intracardiac plasmacytoma usually infiltrates the myocardium and cannot be removed entirely. However, surgical intervention could immediately improve hemodynamics [ 10 , 13 ]. Our patient differed from the previous patients who received surgical intervention for intracardiac plasmacytomas in one crucial aspect.…”