Unusual Presentation of Multiple Myeloma: A Case Series

Author(s):

Manjari Kishore, Vijay Kumar*, Amrita Talwar, Sadhna Marwah, A.S. Nigam and Minakshi Bhardwaj

Introduction: Multiple myeloma is the most common bone malignancy characterized by malignant proliferation of plasma cells leading to production of a monoclonal paraprotein. Varied clinical presentations are noted in the patients like fever, fatigue, weight loss, paraesthesias, hypercalcemia, hyperviscosity, renal failure, bone pain or pathological fractures, cutaneous lesions, etc. We present a series of multiple myeloma cases with unusual presentation over a period of 3 years.

Aims & Objective: To study the unusual clinico-hematological and histopathological presentation in patients with multiple myeloma.

Materials & methods: In this study, we reviewed bone marrow aspirate & biopsy slides in our hospital from May 2014 to June 2017. Patients diagnosed with multiple myeloma were selected. The patients’ clinical information, hematological and histological findings were obtained from the medical records department and correlation was done.

Results: We found a total of 11 cases of multiple myeloma with unusual and rare presentations. Proper clinical, radiological, hematological and histopathological correlation was done before giving a final diagnosis in these cases. Unusual cutaneous and gastrointestinal involvement of multiple myeloma was noted, especially in younger individual, making our study much rarer.

Conclusion: Multiple myeloma is a debilitating malignancy. In the past few years, substantial progress has been noted in treatment of this entity. Early diagnosis of multiple myeloma along with appropriate management will prevent serious complications, especially in younger individuals. The present case series attempts to make an effort to study the clinicopathological correlation in cases of multiple myeloma and associated rare and unusual presentations.