Case of non‐secretory multiple myeloma eventually diagnosed by <sup>18</sup>F‐FDG PET/CT

Haratake, Daisuke; Kanno, Keishi; Ichinohe, Tatsuo; Ito, Masanori

doi:10.1002/ccr3.5628

Cited by 1 publication

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“…[ 1 ] Characterized by plasma cells in bone marrow to produce a large number of monoclonal immunoglobulin, deposition in the tissues or organs, causing high viscosity syndrome, amyloidosis, marrow infiltration, bone lesions, renal dysfunction and a series of pathological changes, the common clinical manifestations of “CRAB” symptoms (calcium elevation, renal insufficiency, anemia, bone disease). [ 2 ] According to the type of M protein, MM can be divided into: IgG, IgA, IgD, IgM, and IgE type, light chain, double clone, and nonsecretory type.…”

Section: Introductionmentioning

confidence: 99%

A case report: Nonsecretory multiple myeloma presenting with bone pain

Geng,

Li,

et al. 2024

Medicine

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Rationale: Nonsecretory multiple myeloma (NSMM) is a rare subtype of multiple myelom, occurring in 1% to 2% of multiple myelom and characterized by the inability of clonal plasma cells to synthesize or secrete immunoglobulins. We describe a 71-year-old male patient who began with bone pain and was referred to hospital several times, but was not properly diagnosed and effectively treated. Patient concerns: A 71-year-old male patient visited our hematology department, complaining of lumbago for 1 year and back pain for half a year. Diagnoses: Low-dose whole-body bone computed tomography: multiple bone destruction of the sternum, ribs, multiple vertebrae and accessories of the spine, pelvis, bilateral humerus, and proximal femur. Monoclonal plasma cells accounted for 17.5% of nuclear cells in bone marrow puncture smear. Fluorescence in situ hybridization detected amplification of CKS1B (1q21) gene. Immunofixation electrophoresis negative. About 10.72% of monoclonal plasma cells were detected by flow cytometry. Finally, he was diagnosed with NSMM. Interventions: The patients received VCD chemotherapy (bortezomib 1.3 mg/m2, d1, d4, d8, d11; cyclophosphamide 300 mg/m2, d1–2, d8–9; dexamethasone sodium phosphate 20 mg, d1–2, d4–5, d8–9, d11–12, once every 21 days). Outcomes: After 2 cycles of VCD treatment, the symptoms of bone pain were significantly relieved, and the efficacy was evaluated as partial response. Follow-up chemotherapy will continue to be completed on schedule. We will continue to follow up to further evaluate the overall survival and progression-free survival. Lessons: This case shows that NSMM is easily missed or misdiagnosed.

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Section: Introductionmentioning

confidence: 99%