A Rare Case of Multiple Myeloma Presenting As Lytic Lesion of the Rib

Sharma, Dhruva; Rawat, Vivek; Yadav, Rajkumar

doi:10.7860/jcdr/2016/17505.7471

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…It is usually related to secondary causes such as congestive heart failure, chronic renal failure, pulmonary infection, serious hypoalbuminemia and thrombosis. MPE with rib lesion is rarer and poses a great diagnostic challenge in need of better strategic approaches (5). Laboratory ndings may reveal abnormal globulin, IgA, IgG, A/G ratio, or Bence-Jones protein; however, these are often insensitive and lagging like this case.…”

Section: Discussionmentioning

confidence: 80%

An Uncommon Etiology for Pleural Effusion with Rib Lesion in a 78-year-old Woman: A Case Report

Qin

Ren

Jiang

et al. 2020

Preprint

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Background: Pleural effusion with rib lesion is generally considered as metastasis of thoracic carcinoma or rib tuberculosis and tuberculous pleuritis. Myelomatous pleural effusion with rib lesion is rare and poses a great diagnostic challenge. We described an easily-misdiagnosed extrapulmonary disease with concomitant pulmonary and rib manifestations, bilateral pleural effusion with lytic rib lesion in multiple myeloma, in order to raise awareness of this disease and avoid misdiagnose. Case presentation: A 78-year-old woman was referred to the thoracic department with chest distress, breathlessness, poor appetite and weight loss for 3 months. Chest computed tomography demonstrated bilateral pleural effusion and lytic lesion on the left 5th rib. Whole-body bone scan showed the intense uptake lesions on the sixth, seventh vertebrae and a central defect with the peripheral uptake of the "donut"-like change sign on the left 5th rib. Percutaneous CT-guided core biopsy for the rib lesion was performed and the diagnosis was multiple myeloma. Combined chemotherapy and supportive treatment were prescribed. She did not respond to the therapy and died 3 months later due to pleural cavity infection and cardiopulmonary failure.Conclusion: Some uncommon extrapulmonary diseases with concomitant pulmonary and rib manifestations should be reminded in order to avoid misdiagnose. Extramedullary multiple myeloma can affect any tissue and is an aggressive entity with poor prognosis. Percutaneous CT-guided core biopsy for the rib lesion is of higher positive rate than pleural fluid cytology and more minimally invasive than pleural biopsy via thoracoscope or rib excision biopsy.

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Section: Discussionmentioning

confidence: 80%

An Uncommon Etiology for Pleural Effusion with Rib Lesion in a 78-year-old Woman: A Case Report

Qin

Ren

Jiang

et al. 2020

Preprint

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“…Despite radiotherapy and chemotherapy after total resection, 5-year survival in MM has been reported to be below 10%. The mean follow-up period of the patients was 26.2 months, and 2 patients passed away (11,12).…”

Section: Discussionmentioning

confidence: 99%

Approach to chest wall masses: Analysis of a single-center outcomes

Işık¹,

İnan²,

Karataş³

et al. 2021

GMJ

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Methods:We retrospectively evaluated the medical records of patients with a chest wall mass, who were admitted between January 2003 and December 2019. The data related to age, gender, chief complaints on admission, tumor localization, requirement of surgical treatment, length of hospital stay, histopathological diagnosis, recurrence, morbidities and mortality were recorded. Results:The total sample included 185 patients [mean age (range): 37.6 years (12 to 88), male gender: 144 (77.8%)]. The mean length of hospitalization was 6.62 days (1-35). The most common complaints on admission were a palpable mass (n=60, 32.4%), pain (n=59, 31.9%), and pain and a palpable mass (n=36, 19.4%). Surgery was required in 166 (89.8%) patients. More than one surgery was performed in 8 (4.8%) patients. There were 118 (71%) benign and 48 (29%) malignant histopathologic results. The most common primary chest wall malignancies were chondrosarcoma and Ewing sarcoma. Conclusions:The majority of patients with a chest wall mass underwent surgery in this 16-year dataset. Chondrosarcoma and Ewing sarcoma were the most common primary malignancies. While most were benign tumors, a secondary intervention was required in a small percentage of patients.

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A Rare Case of Multiple Myeloma Presenting As Lytic Lesion of the Rib

Cited by 2 publications

References 12 publications

An Uncommon Etiology for Pleural Effusion with Rib Lesion in a 78-year-old Woman: A Case Report

An Uncommon Etiology for Pleural Effusion with Rib Lesion in a 78-year-old Woman: A Case Report

Approach to chest wall masses: Analysis of a single-center outcomes

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