Cutaneous Plasmacytoma: Metastasis of Multiple Myeloma at the Fracture Site

Abstract

Multiple myeloma (MM) can be defined as a malignancy with monoclonal plasma cell proliferation. A 66-year-old man presented with pruritic erythematous to purplish plaque grouped nodule with black pigmentations and purpura on the right forearm. The patient was diagnosed with MM about five years prior to the visit at our hospital. Erythematous plaque on his right arm grew rapidly in size over one month and appeared about seven months after the fracture surgery. Skin biopsy showed multiple plasma cell infiltration with monoclonality for lambda light chain, which was consistent with cutaneous plasmacytoma. The patient refused to be treated and died two months later. We herein report an interesting case of cutaneous plasmacytoma at the surgical site of fracture repair.

Multiple cutaneous nodules on the abdomen of an immunosuppressed patient

“…Moreover, they can be classified into primary or secondary to tumor spread from MM or from primary EMP of other tissues. 1,2 In our case, the patient was diagnosed with a secondary cutaneous plasmacytoma in the setting of an established diagnosis of MM. Cutaneous involvement in patients with MM occurs in less than 2% of the cases and is generally associated with advanced stages of the disease, being therefore considered a bad prognostic sign.…”

“…Extramedullary plasmacytomas (EMPs) occur outside the bone marrow, a characteristic that distinguishes them from the more common medullary plasmacytomas. Moreover, they can be classified into primary or secondary to tumor spread from MM or from primary EMP of other tissues 1,2 . In our case, the patient was diagnosed with a secondary cutaneous plasmacytoma in the setting of an established diagnosis of MM.…”

Cutaneous involvement by multiple myeloma presenting as erythematous indurated plaques at the site of cardiac pacemaker insertion

“…Common sites involved are the trunk and extremities; however, rare cases involving surgical sites such as pacemaker insertion or fracture sites have been described in the literature. 3 , 4 , 5 The mechanism for these occurrences at sites of trauma is not well understood, though it may potentially involve local inflammatory mediators released following surgery, which contribute to the clonal expansion of a plasma cell population. 3…”