Extramedullary Cardiac Multiple Myeloma—A Case Report and Contemporary Review of the Literature

Extramedullary Plasmacytoma Involving the Heart: A Case Report and Focused Literature Review

“…Second treatment modalities, such as surgical excision, systemic/local intrapericardial chemotherapy, or high-dose steroid, are often included as adjunct therapy [2,4,[18][19]. Single modality treatment is relatively rare and the outcomes were generally poorer [1,20]. Vigo et al reviewed 11 cases and concluded that RT combined with systemic therapy resulted in better outcomes [3].…”

“…Based on the above findings, SEP was diagnosed due to the absence of plasma cell monoclonality or myeloma defining features. Immunoglobulin-producing plasma cell tumors are known to cause amyloid deposition in various organs including the heart [1,4]. In order to rule out cardiac amyloidosis, a cardiac MRI was ordered and demonstrated the mass infiltrated and replaced most of the anterior, anteroseptal, and anterolateral wall of the LV, resulting in myocardial stiffening with limited radial contraction at the level of the infiltration.…”

“…Primary cardiac tumors are rare conditions. Only around 50 cases of cardiac plasmacytoma have been reported from 1977 to 2020 [1][2][3]. Thus, experience in disease diagnosis and management is limited.…”

Treatment of relapsed multiple myeloma complicated by cardiac extramedullary plasmacytoma with D-PACE chemotherapy

“…Coakley et al recently published a review of extramedullary cardiac MM that included 34 cases since 1990 1. Typical findings in patients with cardiac EMPs include pericardial effusion with or without cardiac tamponade.…”

“…Coakley et al described a case series and review of literature including 34 patients which highlighted the demographics and characteristics of cardiac EMPs; however, information regarding response to specific chemotherapeutic regimens is limited 1. D-PACE (dexamethasone, cisplatin (Platinol), doxorubicin (Adriamycin), cyclophosphamide, and etoposide) is a chemotherapeutic regimen that has been studied in cases of relapsed and refractory MM with response rates of approximately 50% 2 3.…”