Tahiliani N, Kataria P, Patel A, Kendre P
Department of Medical Oncology, GCRI, Ahmedabad, Gujarat, India.
J Postgrad Med. 2018 Oct-Dec;64(4):243-246. doi: 10.4103/jpgm.JPGM_623_17.
Multiple myeloma (MM) is a monoclonal gammopathy, also known as the malignant proliferation of plasma cells, presenting with typical complications such as hypercalcemia, osteolytic bone lesions, anemia, renal insufficiency, and frequent infections. Central nervous system (CNS) involvement in MM in the form of parenchymal involvement is very uncommon and has been reported only in 1% of patients. CNS involvement as an initial presentation is very rare and has poor prognosis. Also specific treatment guidelines do not exist for the treatment of such patients. We present here a case of a 40-year-old female patient, with complaints of headache and left eye proptosis followed by left-sided hemiparesis, who after complete workup was diagnosed as a de novo case of stage III extramedullary MM with CNS involvement. Patient was treated with whole brain radiation followed by BCD regimen (injection of bortezomib, injection of cyclophosphamide, and tablet dexamethasone). After three cycles of chemotherapy, patient succumbed in view of consolidation and renal failure.
多发性骨髓瘤（MM）是一种单克隆丙种球蛋白病，也称为浆细胞恶性增殖，常伴有高钙血症、溶骨性骨病变、贫血、肾功能不全和频繁感染等典型并发症。以实质受累形式出现的MM中枢神经系统（CNS）受累非常罕见，仅在1%的患者中报道过。CNS受累作为首发表现极为罕见且预后不良。此外，针对此类患者的治疗不存在特定的治疗指南。我们在此介绍一例40岁女性患者，主诉头痛和左眼突出，随后出现左侧偏瘫，经过全面检查后被诊断为新发的伴有CNS受累的III期髓外MM病例。患者接受了全脑放疗，随后采用BCD方案（注射硼替佐米、注射环磷酰胺和口服地塞米松片）治疗。化疗三个周期后，患者因病情巩固和肾衰竭死亡。
