Stridor: unusual presentation of multiple myeloma

Abstract

We present a patient with multiple myeloma whose only presenting symptom was stridor caused by a subglottic stenosis. Biopsy suggested the presence of amyloid which prompted immunological investigations that showed hypogammaglobulinaemia and the presence of Bence Jones proteinuria at 0.93 g/24 hours. Further investigation demonstrated a 15 per cent plasma cell infiltrate into the bone marrow and a lytic lesion in the mid-shaft of the right femur. Chemotherapy and localized radiotherapy were commenced. This is a most unusual presentation of multiple myeloma and shows that immunoglobulin profiles should be properly investigated in such cases.

Extramedullary plasmacytomas in the head and neck region

“…Besides serum and urine analysis, histochemical peroxidase-anti-peroxidase stainings oVer help diVerentiating EMP and MM. Until now, an approximate 100 cases of EMP are reported in literature [26][27][28][29][30][31][32][33] of which 25 as metastasis of MM [34][35][36][37]. The diagnosis of laryngeal EMP is diYcult because of the non-speciWc symptoms and the mucosa covering the tumour [33].…”