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全膝关节置换术后多发性骨髓瘤的髓外复发:对骨科医生的启示——病例报告及文献综述

Extramedullary Relapse of Multiple Myeloma After Total Knee Arthroplasty: Implications for Orthopaedic Surgeons-A Case Report and Literature Review.

作者信息

Hefelfinger Donald C, Sareini Mohamed-Ali, Moore Drew D

机构信息

Department of Orthopedic Surgery, Corewell Health East William Beaumont University Hospital, Royal Oak, MI, USA.

出版信息

Arthroplast Today. 2025 Sep 3;35:101834. doi: 10.1016/j.artd.2025.101834. eCollection 2025 Oct.

Abstract

Multiple myeloma (MM) is a hematologic B-cell malignancy characterized by clonal plasma cell proliferation in the bone marrow. Extramedullary disease is a more aggressive form of MM, in which monoclonal cells proliferate outside the bone marrow, forming plasmacytomas. This case highlights a 56-year-old male presenting with an extramedullary recurrence of MM in the soft tissue surrounding the incision site of his total knee arthroplasty. Fortunately, following radiation and chemotherapy, his most recent evaluation demonstrated complete resolution of the nodules within the radiation field. As orthopaedic surgeons, this case serves as an important reminder to remain vigilant about prior malignancies that may complicate perioperative management.

摘要

多发性骨髓瘤(MM)是一种血液系统B细胞恶性肿瘤,其特征是骨髓中克隆性浆细胞增殖。髓外疾病是MM的一种更具侵袭性的形式,其中单克隆细胞在骨髓外增殖,形成浆细胞瘤。本病例重点介绍了一名56岁男性,其在全膝关节置换术切口部位周围的软组织中出现了MM的髓外复发。幸运的是,经过放疗和化疗后,他最近的评估显示放疗区域内的结节已完全消退。作为骨科医生,该病例有力地提醒我们要对可能使围手术期管理复杂化的既往恶性肿瘤保持警惕。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7900/12445598/1d87c6171317/gr1.jpg

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