Radiation Oncology, The Aga Khan University Hospital, Karachi, Pakistan
Medical Oncology, The Aga Khan University Hospital, Karachi, Pakistan.
BMJ Case Rep. 2024 Aug 6;17(8):e260485. doi: 10.1136/bcr-2024-260485.
Cutaneous involvement is an uncommonly encountered manifestation in multiple myeloma (MM), more commonly observed in patients with aggressive subtypes, and often resistant to conventional therapies. Due to its infrequency, reported clinical characteristics have been diverse and relatively non-specific. Particularly uncommon is lower extremity involvement. In this case report, we present a unique case of a patient with refractory immunoglobulin G lambda MM, who subsequently developed recurrence in the lower leg, while being on systemic therapy. Initially, the lesion resembled squamous cell carcinoma, posing a diagnostic challenge. Through meticulous histopathological and immunohistochemical evaluation, cutaneous involvement by MM was confirmed. This case highlights the importance of maintaining a high clinical suspicion for cutaneous involvement in patients with MM who present with new skin lesions, as early diagnosis is crucial for appropriate management.
皮肤受累在多发性骨髓瘤（MM）中并不常见，更常见于侵袭性亚型的患者，且常对常规治疗产生抵抗。由于其罕见性，报道的临床特征多种多样且相对非特异性。下肢受累尤其罕见。在本病例报告中，我们介绍了一例独特的难治性免疫球蛋白 G 型 lambda 多发性骨髓瘤患者，在接受全身治疗时，其小腿随后出现复发。最初，病变类似于鳞状细胞癌，这对诊断构成了挑战。通过细致的组织病理学和免疫组织化学评估，证实了 MM 皮肤受累。本病例强调了对于出现新皮肤病变的 MM 患者，保持对皮肤受累的高度临床怀疑的重要性，因为早期诊断对适当的管理至关重要。
