Isolated Non-Secretory Extramedullary Relapse of Multiple Myeloma Responded Completely to Localized Radiotherapy
Introduction: Non-secretory multiple myeloma (NSMM) is a rare form of multiple myeloma (MM) that is often difficult to detect and has not yet been well characterized. This is due to the lack of production or the presence of monoclonal protein (MP) levels below levels detectable by testing such as se...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2024-03-01
|
| Series: | Case Reports in Oncology |
| Subjects: | |
| Online Access: | https://beta.karger.com/Article/FullText/536675 |
| _version_ | 1797223994142752768 |
|---|---|
| author | Danny Dawd Shiv Kapur Rouslan Kotchetkov |
| author_facet | Danny Dawd Shiv Kapur Rouslan Kotchetkov |
| author_sort | Danny Dawd |
| collection | DOAJ |
| description | Introduction: Non-secretory multiple myeloma (NSMM) is a rare form of multiple myeloma (MM) that is often difficult to detect and has not yet been well characterized. This is due to the lack of production or the presence of monoclonal protein (MP) levels below levels detectable by testing such as serum/urine electrophoresis and immunofixation. Case Presentation: Two patients of ours were being treated for MM with typical courses of systemic therapy. By the third-line therapy, both developed an extramedullary mass, one in the pelvis and the other in the neck. In both cases, blood work showed no measurable MP, normal free light chain levels, and unremarkable skeletal surveys. Secondary malignancies were suspected due to the clinical presentation in each case, and biopsies confirmed the presence of non-secretory plasmacytomas. Both patients were only treated with localized radiotherapy with a total dose of 2,000 cGy in 5 fractions over 1 week. Ultimately, this resolved the original masses with no residual tumors. No changes had to be made to their systemic therapies, and both patients remained stable. Conclusion: NSMM relapse is not unusual and should be suspected in patients with relapsed refractory disease. Relapse should be confirmed by a tissue biopsy, and secondary malignancies should be ruled out. Radiotherapy is an excellent option to treat localized relapse and preserve the current line of systemic anti-myeloma therapy. |
| first_indexed | 2024-04-24T13:46:04Z |
| format | Article |
| id | doaj.art-4d997a7dd4084795a176b56e798c8dcc |
| institution | Directory Open Access Journal |
| issn | 1662-6575 |
| language | English |
| last_indexed | 2024-04-24T13:46:04Z |
| publishDate | 2024-03-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Oncology |
| spelling | doaj.art-4d997a7dd4084795a176b56e798c8dcc2024-04-04T06:12:58ZengKarger PublishersCase Reports in Oncology1662-65752024-03-0117142342910.1159/000536675536675Isolated Non-Secretory Extramedullary Relapse of Multiple Myeloma Responded Completely to Localized RadiotherapyDanny Dawd0Shiv Kapur1Rouslan Kotchetkov2Department of Medicine, University of Western Ontario, London, ON, CanadaDepartment of Pathology, Royal Victoria Regional Health Centre, Barrie, ON, CanadaDepartment of Oncology, Royal Victoria Regional Health Centre, Barrie, ON, CanadaIntroduction: Non-secretory multiple myeloma (NSMM) is a rare form of multiple myeloma (MM) that is often difficult to detect and has not yet been well characterized. This is due to the lack of production or the presence of monoclonal protein (MP) levels below levels detectable by testing such as serum/urine electrophoresis and immunofixation. Case Presentation: Two patients of ours were being treated for MM with typical courses of systemic therapy. By the third-line therapy, both developed an extramedullary mass, one in the pelvis and the other in the neck. In both cases, blood work showed no measurable MP, normal free light chain levels, and unremarkable skeletal surveys. Secondary malignancies were suspected due to the clinical presentation in each case, and biopsies confirmed the presence of non-secretory plasmacytomas. Both patients were only treated with localized radiotherapy with a total dose of 2,000 cGy in 5 fractions over 1 week. Ultimately, this resolved the original masses with no residual tumors. No changes had to be made to their systemic therapies, and both patients remained stable. Conclusion: NSMM relapse is not unusual and should be suspected in patients with relapsed refractory disease. Relapse should be confirmed by a tissue biopsy, and secondary malignancies should be ruled out. Radiotherapy is an excellent option to treat localized relapse and preserve the current line of systemic anti-myeloma therapy.https://beta.karger.com/Article/FullText/536675multiple myelomarelapseplasmacytomaextramedullary |
| spellingShingle | Danny Dawd Shiv Kapur Rouslan Kotchetkov Isolated Non-Secretory Extramedullary Relapse of Multiple Myeloma Responded Completely to Localized Radiotherapy Case Reports in Oncology multiple myeloma relapse plasmacytoma extramedullary |
| title | Isolated Non-Secretory Extramedullary Relapse of Multiple Myeloma Responded Completely to Localized Radiotherapy |
| title_full | Isolated Non-Secretory Extramedullary Relapse of Multiple Myeloma Responded Completely to Localized Radiotherapy |
| title_fullStr | Isolated Non-Secretory Extramedullary Relapse of Multiple Myeloma Responded Completely to Localized Radiotherapy |
| title_full_unstemmed | Isolated Non-Secretory Extramedullary Relapse of Multiple Myeloma Responded Completely to Localized Radiotherapy |
| title_short | Isolated Non-Secretory Extramedullary Relapse of Multiple Myeloma Responded Completely to Localized Radiotherapy |
| title_sort | isolated non secretory extramedullary relapse of multiple myeloma responded completely to localized radiotherapy |
| topic | multiple myeloma relapse plasmacytoma extramedullary |
| url | https://beta.karger.com/Article/FullText/536675 |
| work_keys_str_mv | AT dannydawd isolatednonsecretoryextramedullaryrelapseofmultiplemyelomarespondedcompletelytolocalizedradiotherapy AT shivkapur isolatednonsecretoryextramedullaryrelapseofmultiplemyelomarespondedcompletelytolocalizedradiotherapy AT rouslankotchetkov isolatednonsecretoryextramedullaryrelapseofmultiplemyelomarespondedcompletelytolocalizedradiotherapy |