Maharaj Shivesh, Mungul Sheetal
Department of Otorhinolaryngology/Head and Neck Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of The Witwatersrand, Johannesburg 2193, South Africa.
Department of Otorhinolaryngology/Head and Neck Surgery, Charlotte Academic Hospital, University of The Witwatersrand, Johannesburg 2150, South Africa.
Biomed Rep. 2020 Oct;13(4):28. doi: 10.3892/br.2020.1335. Epub 2020 Jul 22.
Multiple myeloma is a biologically diverse, malignant disease that involve plasma cells. Multiple myeloma is characterized by the unrestrained proliferation of monoclonal plasma cells within the bone marrow. In the present case report, the case of a human immunodeficiency virus (HIV) positive patient with an initial manifestation of extramedullary myeloma involving the parotid gland is described. The patient had been on antiretrovirals for the last two years. A Medline, Embase, Scopus and Google Scholar search was performed using the key words: 'Parotid extramedullary myeloma AND HIV' as part of the literature review. A 46-year-old female presented to our hospital with a 6-month history of a painful mass on the left side of the face, involving the parotid area, with rapid growth in the preceding month. There was associated fever, body pains and difficulty opening the mouth. This resulted in difficulty in mastication and she also reported pain on swallowing. She did not notice any weakness of her face on the left side. She had no complaints regarding her eyes, such as visual disturbances, eye pain, or an inability to close the eye on the affected side. The patient was diagnosed with HIV infection 2 years prior, and had been on highly active antiretroviral therapy (HAART) since the diagnosis. There is no consensus regarding a treatment protocol for HIV positive patients on HAART and multiple myeloma. However, based on the clinical case report and a review of the relevant literature, the treatment should include high doses of a combination of chemotherapeutic agents. Although multiple myeloma is considered incurable, all patients should be started on treatment with the goal of preventing further complications.
多发性骨髓瘤是一种生物学特性多样的恶性疾病，累及浆细胞。多发性骨髓瘤的特征是骨髓内单克隆浆细胞不受控制地增殖。在本病例报告中，描述了一例人类免疫缺陷病毒（HIV）阳性患者，其最初表现为累及腮腺的髓外骨髓瘤。该患者在过去两年中一直在接受抗逆转录病毒治疗。作为文献综述的一部分，使用关键词“腮腺髓外骨髓瘤和HIV”在Medline、Embase、Scopus和谷歌学术上进行了检索。一名46岁女性因左侧面部疼痛性肿块6个月前来我院就诊，肿块累及腮腺区域，在前一个月迅速增大。伴有发热、全身疼痛和张口困难。这导致咀嚼困难，她还报告吞咽时疼痛。她未注意到左侧面部有任何无力。她没有关于眼睛的任何不适，如视力障碍、眼痛或患侧闭眼无力。该患者2年前被诊断为HIV感染，自诊断以来一直在接受高效抗逆转录病毒治疗（HAART）。对于接受HAART治疗的HIV阳性患者和多发性骨髓瘤的治疗方案尚无共识。然而，根据临床病例报告和相关文献综述，治疗应包括高剂量的联合化疗药物。虽然多发性骨髓瘤被认为无法治愈，但所有患者都应开始治疗，目标是预防进一步的并发症。
