International Journal of Hematology-Oncology and Stem Cell Research 2017. 11(4):281-285.

Multiple Extramedullary Plasmacytoma in A Setting of Complete Bone Marrow Remission: Food for Thought
Dr. Preety Negi, Kingsley Pamela Alice, Jomi Chinnu, Mathew Amrith, George Sneha, Immanuel Vivek, Abraham Puliyelil Abraham

Abstract


Extramedullary plasmacytoma as a mode of relapse in multiple myeloma (MM) is unusual. Current recommendations do not incorporate the routine use of 18-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) imaging prior to haematopoietic stem cell transplant (HSCT) in MM. We report a case of relapsed MM with complete remission as per IMWG criteria. In the interim period, before the HSCT, the patient had localizing neurological signs and symptoms attributed to multiple extramedullary plasmacytomas. The uniqueness of this case is that this patient after complete marrow remission with no obvious external masses had unexpected, symptomatic multiple extramedullary plasmacytomas. This case illustrates the need for integration of FDG PET/CT imaging into routine pre-HSCT investigations in relapsed MM to prevent missing any asymptomatic extramedullary plasmacytomas.


 


Keywords


Haematopoietic stem cell transplantation, Multiple myeloma, Extramedullary plasmacytoma, Positron emission tomography

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