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Abstract
A NEWLY DIAGNOSED MULTIPLE MYELOMA WITH EXTRAMEDULLARY INVOLVEMENT OF THE LIVER: A RARE CASE REPORT FROM SYRIA
Firas Hussein M. D.* and Zainab Omar M. D.
ABSTRACT
Multiple myeloma is a malignant clonal proliferation of plasma cells in the bone marrow preceded by monoclonal gammapathy of undetermined significant. Extramedullary myeloma is an uncommon finding refers to the infiltration of neoplastic monoclonal plasma cells in either organs or soft tissues, with a more aggressive clinical course and poorer outcome. We herein describe a case of 65-year-old patient who presented with fatigue and severe low back pain. Ultrasound and CT scan of the abdomen showed multiple liver nodules. Biopsy of the liver nodules showed CD138 and kappa light chain-restricted positive cells consistent with extramedullary spread of multiple myeloma to the live. After 2 cycles of Cyclophosphamide, Revlimid, and Dexamethasone (CRd) the patient showed a partial response. Therefore, we decided to follow-up the same regimen. No controlled prospective studies have defined the standard treatment for multiple myeloma with extramedullary spread particularly to the liver. Treatment of multiple myeloma with extramedullary disease follows guidelines for multiple myeloma.
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