scholarly journals A case of multiple myeloma presenting as scalp swelling with intracranial extension

2013 ◽  
Vol 04 (04) ◽  
pp. 445-448 ◽  
Author(s):  
Satya Bhusan Senapati ◽  
Sudhansu Sekhar Mishra ◽  
Manmath Kumar Dhir ◽  
Srikanta Das ◽  
Kalpalata Tripathy
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Cells ◽  
Bone Erosion ◽  
Malignant Lesion ◽  
Malignant Neoplasm ◽  
Intracranial Extension ◽  
Histopathological Study ◽  
Skull Bone ◽  
Characteristic Features

ABSTRACTMultiple myeloma is a malignant neoplasm of bone marrow affecting plasma cells. It is usually detected in skull bone with characteristic features of multiple punched-out lesions. Its presentation as a solitary scalp swelling with underlying skull bone erosion and intracranial extension is very rare. A 35-year-old female presented to us with complains of rapidly growing left-side scalp swelling with right-side paresis and simple partial seizure of right upper limb. Local examination, X-ray skull, CT scan, and MRI of brain were suggestive of a malignant lesion. Near total excision of lesion was done. Histopathological study was suggestive of plasmacytoma of skull. Bone marrow study further confirmed it as a case of multiple myeloma. Cases presenting with solitary osteolytic skull lesions, possibility of plasmacytoma, or multiple myeloma should be kept in mind.

scholarly journals Multiple Myeloma Involving Left Hemicranium

2022 ◽  
Author(s):  
Jutty Parthiban ◽  
B. Udaykumar ◽  
Sudeendra Reddy Peddireddy ◽  
Balasubramaniam Prakash ◽  
Vighnesh Kandha Kumar
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Malignant Neoplasm ◽  
Brain Parenchyma ◽  
Intracranial Extension ◽  
Parietal Region ◽  
Skull Bone ◽  
X Ray ◽  
Mri Brain ◽  
Ct And Mri

AbstractMultiple myeloma (MM) is a malignant neoplasm of bone marrow affecting plasma cells. It is commonly seen as multiple punched-out lesions in the skull bone as a characteristic feature. Its presentation as hemicranial involvement with intracranial extension is rare. A 46-year-old male presented with left side scalp swelling, prominent over parietal region. X-ray showed multiple punched out lesions involving left hemicranium. CT and MRI brain showed intracranial extension of lesion without brain parenchyma invasion. He was treated with biopsy of lesion followed by chemotherapy.

scholarly journals Multiple Myeloma - Atypical Presentation - Clinicopathological Correlation

2021 ◽  
Vol 10 (40) ◽  
pp. 3526-3532
Author(s):  
Emani Usha Bhargavi ◽  
Vaddadi Suresh
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Cells ◽  
Wide Spectrum ◽  
Case Series ◽  
Malignant Neoplasm ◽  
Routine Practice ◽  
Cutaneous Lesions ◽  
Clinical Presentations ◽  
Case Series Study

BACKGROUND Multiple myeloma, malignant neoplasm of plasma cells producing monoclonal para protein is one of the most common haematological malignancies we see in our routine practice. Multiple myeloma has varied and diverse clinical presentations, of which most common clinical features will be anaemia, bone pain, fever, fatigue, weight loss, paraesthesia, renal failure, pathological fractures, cutaneous lesions, etc. We hereby, present a series of multiple myeloma cases with unusual presentation over a period of 3 years. The purpose of the study was to evaluate the unusual and rare clinicohaematological presentation in patients with multiple myeloma. METHODS In this case series study, we reviewed bone marrow aspirate & / or biopsy slides in our hospital from January 2017 to January 2020. Patients diagnosed with multiple myeloma were selected. Patients’ clinical information, haematological and other findings were obtained from the medical records department and compiled, and correlation was done. RESULTS We came across a total of 9 cases of multiple myeloma with very unusual and rare clinical presentations. A thorough clinical, radiological, haematological, biochemical and histopathological correlation was done before giving a final diagnosis in these cases. Rare cutaneous and other involvement of multiple myeloma was noted. CONCLUSIONS Multiple myeloma is the most common malignancy with comparatively poor prognosis. However, early diagnosis of multiple myeloma always helps the clinician in improving the outcome and has been shown to have better prognosis. The present case series is an attempt to understand the clinico-pathological correlation, wide spectrum of clinical presentation and associated rarity of presentations. KEY WORDS Myeloma; Lytic Lesions; Bone Marrow

Multiple Myeloma Course with Renal Insufficiency in Young Patient: Case Report

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 26-26
Author(s):  
Hugo Henrique de Freitas Ferreira ◽  
Alessandra Suelen Jardim Silva ◽  
Lenilton Silva DA Silva Júnior ◽  
Gustavo Henrique de Medeiros Oliveira ◽  
Maria das Graças Pereira Araujo ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Young Patient ◽  
Mononuclear Cells ◽  
Plasma Cells ◽  
Serum Proteins ◽  
Conflicts Of Interest ◽  
Young Patients ◽  
Treatment Strategies ◽  
Malignant Neoplasm

Introduction: Multiple myeloma (MM) is a malignant neoplasm characterized by the clonal proliferation of abnormal plasma cells in the bone marrow (OM). The average age of patients diagnosed with MM is approximately 70 years, being relatively uncommon in younger individuals. Objective: To report a case of a young patient with multiple myeloma. Case Description: A 42-year-old male patient presented with continuous and progressive low back pain for 3 months, associated with adynamia, weight loss (10 kg), episodes of constipation and bleeding in the oral cavity in this period. Examinations at the first appointment revealed moderate anemia (Hb 7.4 g / dL), leukocytosis, thrombocytopenia, hypercalcemia, and altered renal function (Cr 5.9 and Ur 178), chest tomography indicating vertebral fracture in T6, T11, L2 and L4. Referred for specialized follow-up, he performed electrophoresis of serum proteins with the presence of a monoclonal peak in the gamma globulin fraction. The immunofixation test confirmed monoclonality for IgA isotype and Kappa light chain (IgA / Kappa). The myelogram showed plasmacytosis of more than 50% of mononuclear cells in the bone marrow. He developed renal failure (with dosage of creatinine of 10.1 mg/ dL. and urea of 208 mg/dL) and hypercalcemia requiring dialysis therapy on the third day of hospitalization, having undergone chemotherapy with Bortezomib, cyclophosphamide and dexamethasone. During this period, infection by the multisensitive S. aureus in catheter occurred and, despite being treated with specific antibiotic therapy, it evolved with clinical worsening and hemodynamic instability and was referred to the Intensive Care Unit, going to death after 2 days. Conclusion: Young patients with MM may study with more aggressive characteristics. Despite the use of new therapeutic agents, more effective treatment strategies need to be studied more for patients in this age group. Disclosures No relevant conflicts of interest to declare.

scholarly journals Treatment Approaches of Multiple Myeloma

2021 ◽  
Author(s):  
Minyahil Alebachew Woldu ◽  
Atalay Mulu Fentie ◽  
Tamrat Assefa Tadesse
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Cells ◽  
Clinical Investigation ◽  
Malignant Neoplasm ◽  
Bone Destruction ◽  
Organ Damage ◽  
Autologous Stem Cell Transplant ◽  
Bone Lesions ◽  
Newly Diagnosed

Multiple Myeloma (MM) is the most common malignant neoplasm of plasma cells that accumulate in bone marrow, leading to bone destruction and marrow failure. Clinical investigation of MM requires the evaluation of bone marrow for plasma cell infiltration, and detection and quantification of monoclonal protein in the serum or urine, and evidence for end-organ damage (i.e., hypercalcemia, renal insufficiency, anemia, or bone lesions). The overall goal of treatment of MM is to improve survival. The treatment landscape and clinical outcome of MM have changed in the last two decades, with an improved median survival of 8–10 years. Management of MM involves induction, consolidation, and maintenance therapy. Currently, Autologous stem cell transplant (ASCT) is considered as the standard care of treatment for newly diagnosed fit MM patients. Multiple combinations of proteasome inhibitors (PIs) and immunomodulatory drugs (IMIDs) such as Thalidomide, lenalidomide, and pomalidomide have been under evaluation in ASCT-eligible and ineligible settings, and studies are still ongoing. For patients with ASCT-eligible newly diagnosed MM, induction therapy with triple drugs should contain an IMiD, a PI, and a corticosteroid, usually lenalidomide-bortezomib-dexamethasone. For ASCT-ineligible patients on lenalidomide with dexamethasone (Rd), with addition of bortezomib or daratumumab can be considered.

scholarly journals Multiple Myeloma, Version 3.2021, NCCN Clinical Practice Guidelines in Oncology

2020 ◽  
Vol 18 (12) ◽  
pp. 1685-1717
Author(s):  
Shaji K. Kumar ◽  
Natalie S. Callander ◽  
Kehinde Adekola ◽  
Larry Anderson ◽  
Muhamed Baljevic ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Plasma Cells ◽  
Malignant Neoplasm ◽  
Bone Destruction ◽  
Solitary Plasmacytoma ◽  
Newly Diagnosed

Multiple myeloma is a malignant neoplasm of plasma cells that accumulate in bone marrow, leading to bone destruction and marrow failure. This manuscript discusses the management of patients with solitary plasmacytoma, smoldering multiple myeloma, and newly diagnosed multiple myeloma.

Bone disease as the first manifestation of systemic AL-amyloidosis

2020 ◽  
Vol 92 (7) ◽  
pp. 85-89
Author(s):  
L. P. Mendeleeva ◽  
I. G. Rekhtina ◽  
A. M. Kovrigina ◽  
I. E. Kostina ◽  
V. A. Khyshova ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Disease ◽  
Plasma Cells ◽  
Interventricular Septum ◽  
Bone Destruction ◽  
Amyloid Deposition ◽  
Bone Lesions ◽  
Al Amyloidosis ◽  
Linear Type

Our case demonstrates severe bone disease in primary AL-amyloidosis without concomitant multiple myeloma. A 30-year-old man had spontaneous vertebral fracture Th8. A computed tomography scan suggested multiple foci of lesions in all the bones. In bone marrow and resected rib werent detected any tumor cells. After 15 years from the beginning of the disease, nephrotic syndrome developed. Based on the kidney biopsy, AL-amyloidosis was confirmed. Amyloid was also detected in the bowel and bone marrow. On the indirect signs (thickening of the interventricular septum 16 mm and increased NT-proBNP 2200 pg/ml), a cardial involvement was confirmed. In the bone marrow (from three sites) was found 2.85% clonal plasma cells with immunophenotype СD138+, СD38dim, СD19-, СD117+, СD81-, СD27-, СD56-. FISH method revealed polysomy 5,9,15 in 3% of the nuclei. Serum free light chain Kappa 575 mg/l (/44.9) was detected. Multiple foci of destruction with increased metabolic activity (SUVmax 3.6) were visualized on PET-CT, and an surgical intervention biopsy was performed from two foci. The number of plasma cells from the destruction foci was 2.5%, and massive amyloid deposition was detected. On CT scan foci of lesions differed from bone lesions at multiple myeloma. Bone fragments of point and linear type (button sequestration) were visualized in most of the destruction foci. The content of the lesion was low density. There was no extraossal spread from large zones of destruction. There was also spontaneous scarring of the some lesions (without therapy). Thus, the diagnosis of multiple myeloma was excluded on the basis based on x-ray signs, of the duration of osteodestructive syndrome (15 years), the absence of plasma infiltration in the bone marrow, including from foci of bone destruction by open biopsy. This observation proves the possibility of damage to the skeleton due to amyloid deposition and justifies the need to include AL-amyloidosis in the spectrum of differential diagnosis of diseases that occur with osteodestructive syndrome.

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