Multiple Myeloma Presenting as Fatal Hyperviscosity Syndrome: A Rare Case Report

Bhagawati, Jahnabi; Agrawal, Abhijeet Kumar; Kumar, Sunil; Acharya, Sourya

doi:10.31782/ijcrr.2021.131716

Cited by 2 publications

(1 citation statement)

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“…A diagnosis of MM is made when a bone marrow biopsy demonstrates at least 10% clonality of plasma cells and one or more myeloma-defining events, such as end-organ damage attributed to the proliferative disorder. Extramedullary disease (EMD) occurs in approximately 10% of patients with MM and is defined as an aggressive soft tissue plasmacytoma of malignant clonal cells that grow independently of the initial bone marrow neoplasm [1][2][3]. Extramedullary involvement often occurs via hematogenous spread into distant organs or soft tissues, including the liver and pleura, and is more prevalent in refractory than newly diagnosed MM [4].…”

Section: Introductionmentioning

confidence: 99%

A Case of Plasmablastic Multiple Myeloma With Extramedullary Disease Manifesting as a Myelomatous Pleural Effusion

Jiffry¹,

Ahmed-khan²,

Rangsipat³

et al. 2022

Cureus

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Multiple myeloma (MM) is a neoplasm of plasma cell origin characterized by the proliferation of immunoglobulin-producing plasma cells in the bone marrow. Extramedullary disease (EMD) occurs in approximately 10% of patients with MM. Myelomatous pleural effusion (MPE) is a possible manifestation of EMD and has been associated with a poorer prognosis.A 66-year-old female was evaluated after an abnormal serum protein electrophoresis that showed a 2.1 g/dL M-spike in the gamma region, highly suggestive of plasma cell dyscrasia. Imaging subsequently confirmed the bony metastasis. A bone marrow biopsy confirmed plasmablastic MM, and she was started on chemotherapy. She presented three months later with bilateral pleural effusions, with cytology revealing neoplastic plasmacytoid cells. Despite transitioning to dexamethasone, cyclophosphamide, etoposide, and cisplatin (the V-DCEP regimen) due to disease progression, her myeloma remained refractory to treatment, and she expired one month later. MPE in MM is associated with a poor prognosis, with a median overall survival (OS) of 13 months in MPE compared to 37 months in other EMDs. A higher tumor burden and greater multisite extra-medullary lesions are also characteristics of MPE in MM. There is no standard of care for the management of EMD, and salvage regimens such as RVD and V-DCEP are commonly employed. The management of MM with EMD remains a challenge, and more investigation is required before effective treatment regimens may be employed in this setting.

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Section: Introductionmentioning

confidence: 99%

A Case of Plasmablastic Multiple Myeloma With Extramedullary Disease Manifesting as a Myelomatous Pleural Effusion

Jiffry¹,

Ahmed-khan²,

Rangsipat³

et al. 2022

Cureus

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A Case Report of the Atypical Presentation of Multiple Myeloma Manifesting as a Sternal Mass

Kaushik,

Manuja,

Devde

et al. 2024

Cureus

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The diagnosis of multiple myeloma (MM) is made based on the presence of either marrow clonal plasma cells > 10% or an extramedullary or bony plasmacytoma confirmed by biopsy. Additionally, at least one of the SLiM (sixty years, light chain ratio, magnetic resonance imaging)-CRAB (calcium elevation, renal insufficiency, anemia, and bone lesions) myeloma-defining events must be present. MM typically presents with symptoms such as fatigue due to anemia, kidney failure, hypercalcemia, and bone pain. It is uncommon, though, for MM to manifest as a single bone mass. We report the case of a 65-year-old male who did not fit the criteria for solitary bone plasmacytoma and presented with an unusual sternal tumor. The patient was diagnosed with MM despite not having any of the traditional symptoms such as low back pain, weight loss, anemia, or hypercalcemia. The diagnosis was based on a bone marrow examination, which showed 50% plasma cells. Radiation therapy and systemic chemotherapy were then used to treat him. The patient's symptoms, radiological findings, and biopsy results are described in detail, emphasizing the difficulty and intricacy of correctly diagnosing this uncommon manifestation of MM. This case highlights the need for a comprehensive and multidisciplinary strategy to diagnose and treat atypical presentations of MM, making sure that all possible diagnostic pathways are investigated in order to achieve accurate and timely diagnosis and treatment.

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Multiple Myeloma Presenting as Fatal Hyperviscosity Syndrome: A Rare Case Report

Cited by 2 publications

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A Case of Plasmablastic Multiple Myeloma With Extramedullary Disease Manifesting as a Myelomatous Pleural Effusion

A Case of Plasmablastic Multiple Myeloma With Extramedullary Disease Manifesting as a Myelomatous Pleural Effusion

A Case Report of the Atypical Presentation of Multiple Myeloma Manifesting as a Sternal Mass

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