Myelomatosis: a case report of an unusual presentation.

BACKGROUND

Multiple myeloma (MM) is a clonalexpansion of plasma cell characterized by skeletal dissemination of malignant plasma cells resulting in the production of homogenous monoclonal immunoglobulin termed the monoclonal (M) protein. MM is the most prevalent cancer after non-Hodgkin's lymphoma and is responsible for 2% of all cancer deaths. Several unusual presentation of MM have been described in the literature. Many serial reports have documented progression of Plasmacytoma to MM, or relapsed into MM after radiation therapy.

STUDY DESIGN

This is a case report of a 36 yr old man with a huge fungating right clavicular mass, with a histological of plasmacytoma (anaplastic variant).

RESULT

The patient's tumour was resistant to radiotherapy, terminating as multiple myeloma, with rapid progression to death within 19 months post diagnosis.

CONCLUSION

This report helps to validate the rapid progression of the anaplastic plasmacytoma variant to disseminated myeloma, and indicates the poor response to radiation therapy. Our patient showed the important poor prognostic features in some plasmacytomas that are characterized by rapid progression to MM, namely tumour size > 5 cm, young age and spinal cord compression.