Summary:We report three cases of massive chest wall plasmacytoma, each greater than 10 cm in diameter, without evidence of overt myeloma, whom we treated with a combination of VAD chemotherapy consolidated by highdose melphalan and autologous peripheral blood stem cell transplantation and radical radiotherapy. All three patients completed all components of their therapy without experiencing any major side effects and one patient has had a durable remission. The other two patients have had disease progression but at sites other than the original tumour.

418Landray Ringrose, Ringrose, Ferner, et al rechallenge with omeprazole resulted in a much greater deterioration of renal function than was apparent at the time of original exposure, suggesting a process of sensitisation.Our report demonstrates the need to consider drugs as a cause of unexplained fever. The serendipitous rechallenge with the suspected agent confirms the diagnosis of omeprazoleinduced pyrexia with bone marrow hypoplasia and interstitial nephritis.