Sanz M A, Mayans J, Martínez J, Caballero O, Marty M L
Med Clin (Barc). 1979 Jul 15;73(3):118-21.
A 46-year-old woman presented and IgG myeloma without metastases at the time of the diagnosis. A complete hematologic remission was achieved with melphalan and prednisone, but the patient then developed a polysymptomatic condition with myelomatous metastases in different organs. In some cases these were confirmed histologically (meninges, stomach, skin, and scalp); in others there was a strong clinical evidence (liver, oral mucosa, lymph nodes, and lumbar vertebra). There were manifestations of the disease in all of these sites, while complete hematologic remission was maintained. The meningeal metastasis was treated by surgery and irradiation with orbital penetration; the lymph nodes were irradiated, and COPP polychemotherapy was given to treat the rest of the metastatic localizations. In this way an apparently remission was achieved temporarily. The incidence of each one of the extraskeletal manifestations in this unusual case of myeloma is reviewed in the literature.
一名46岁女性在诊断时被发现患有IgG骨髓瘤且无转移。美法仑和泼尼松治疗后实现了完全血液学缓解,但随后患者出现多症状状态,不同器官出现骨髓瘤转移。部分病例经组织学证实(脑膜、胃、皮肤和头皮);其他病例则有强有力的临床证据(肝脏、口腔黏膜、淋巴结和腰椎)。所有这些部位均有疾病表现,同时维持了完全血液学缓解。脑膜转移通过手术和眼眶穿透照射进行治疗;对淋巴结进行照射,并给予COPP联合化疗以治疗其余转移部位。通过这种方式暂时实现了明显缓解。本文回顾了该罕见骨髓瘤病例中每种骨外表现的发生率。