1/88. plasmacytoma and upper airway obstruction.Extramedullary plasmacytomas are hematologic malignancies that occur primarily in the head and neck region. They usually involve the submucosal lymphoid tissue of the nasopharynx or paranasal sinuses and present as soft tissue masses, but have not been previously reported to cause airway obstruction. In general, detection of plasmacytoma antedates the eventual development of the systemic hematologic malignancy, multiple myeloma, by months or years. We describe a unique case of acute upper respiratory tract obstruction secondary to compression by an extramedullary plasmacytoma occurring in the neck of a patient with history of long-standing multiple myeloma. Upper airway obstruction may be a manifestation of untreated plasmacytoma. It is imperative for otolaryngologists and head and neck surgeons to be familiar with this entity because total excision, as well as radiation therapy, for plasmacytomas can be curative in patients without underlying overt plasma cell dyscrasias.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/88. Development of IgG lambda multiple myeloma in a patient with cutaneous CD30 anaplastic T-cell lymphoma.We report a patient with an epidermotropic cutaneous T-cell lymphoma which transformed into an anaplastic cutaneous CD30 T-cell lymphoma. Repeated relapses required prolonged systemic puva therapy. Two years after diagnosis, the patient had several episodes of infections of the respiratory tract. serum electrophoresis now revealed significantly reduced polyclonal immunglobulin production and an additional band in the gamma fraction corresponding to IgG lambda monoclonal gammopathy. Thereafter, the patient suffered a pathologic fracture of the dorsolateral 5th rib on the right side and an accumulation of monoclonal plasma cells in the bone marrow confirmed the diagnosis of multiple myeloma (IgG lambda). Accordingly, 6 cycles of cytoreductive chemotherapy (alkeran, decortin) were given. After one year of steady state disease the patient lost weight and bone pain increased while only a few papular eruptions were detectable. radiography showed multiple small osteolytic areas. A few months later he died with signs of bone marrow insufficiency.- - - - - - - - - - ranking = 2.1082078023396keywords = fracture (Clic here for more details about this article) |
3/88. Intraoral corroboration of systemic plasma-cell myeloma. Abbreviated case report.A patient with a previously diagnosed case of multiple myeloma was readmitted for a pathologic fracture of the hip. Intraoral examination revealed a soft-tissue swelling over the right posterior mandibular ridge. Radiographs showed multiple radiolucent areas of the maxilla and mandible. A needle-biopsy technique was used to confirm the diagnosis of intraoral manifestations of plasma-cell myeloma.- - - - - - - - - - ranking = 2.1082078023396keywords = fracture (Clic here for more details about this article) |
4/88. association of posterior rib fractures with exaggerated kyphosis and sternal collapse.The ribs, sternum, and vertebrae all play an important role in stabilizing the thorax. Failure of one of these components places additional stress on the other supporting structures. We present a case of a 62-year-old man with multiple myeloma and osteopenia who sustained fractures to all three components.- - - - - - - - - - ranking = 10.541039011698keywords = fracture (Clic here for more details about this article) |
5/88. Plasma cell neoplasms in the young.multiple myeloma, a disease of the elderly, is extremely rare in those below 30 years of age. Two patients with multiple myeloma diagnosed at 20 years and 18 years are described. Both presented with extradural cord compression, lytic bone lesions and bone marrow plasmacytosis. One patient received combination chemotherapy and radiotherapy and survived for 14 years. A literature review is presented.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
6/88. Orbital T-cell lymphoma in a multiple myeloma patient.PURPOSE: To report an 82-year-old woman with multiple myeloma who developed an orbital T-cell lymphoma concomitantly. methods: The patient presented with left upper eyelid swelling. magnetic resonance imaging demonstrated an orbital mass compressing the eyeball. The mass was excised for diagnostic purposes and orbital decompression. RESULTS: Histopathologic and immunohistochemical evaluation identified the mass as a T-cell lymphoma. The disease progressed rapidly despite chemotherapy. CONCLUSIONS: Orbital T-cell lymphoma is rare and we are unaware of previous reports of orbital T-cell lymphoma in patients with multiple myeloma.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
7/88. Extraosseous epidural IgD myeloma presenting with compression myelopathy.An 85-year-old man presented with acute transverse myelopathy: flaccid paraplegia, superficial and deep sensory disturbance below Th6 and loss of urinary sensation. Spinal magnetic resonance image showed an epidural mass compressing the spinal cord at the level of C7 to Th2. immunoelectrophoresis revealed the presence of immunoglobulin d (IgD)-lambda M protein. Chemotherapy markedly improved both the haematologic aspect and tumor size, but not the motor deficit. In IgD myeloma, extraosseous spreads occur frequently, but extraosseous epidural tumors causing compression myelopathy are relatively rare. To our knowledge, this is the fourth report of cases.- - - - - - - - - - ranking = 5keywords = compression (Clic here for more details about this article) |
8/88. multiple myeloma associated with extramedullary plasmacytoma causing nerve root compression: a case report.multiple myeloma associated with extramedullary plasmacytoma at initial presentation is rare. We describe a 45-year-old female patient with an initial presentation of low back pain and right side L5, S1 radiculopathy. There was no evidence of vertebral involvement but an epidural tumor was found later during neurosurgical intervention. The final diagnosis was immunoglobulin g, kappa multiple myeloma complicated with spinal root compression by an extramedullary plasmacytoma. No osteolytic lesion was noted over the length of the spine. pathology revealed high-grade plasmablastic myeloma. During the clinical course, the patient was refractory to induction chemotherapy, and there was progressive deterioration of renal function. urinary tract infection by morganella morganii and pulmonary infection of unknown cause developed 5 months later, and the patient died.- - - - - - - - - - ranking = 5keywords = compression (Clic here for more details about this article) |
9/88. Intraoperative stroke under epidural anesthesia for bipolar hemiarthroplasty in a patient with multiple myeloma: a case report.A 56-yr-old, 58-kg woman with right femoral neck fracture underwent right bipolar hemiarthroplasty. Her medical problems included diabetes mellitus and multiple myeloma. Epidural anesthesia was performed uneventfully. No other drug except for local anesthetic (2% lidocaine) was administered during the procedure. Unfortunately, we "witnessed" the dramatically hemodynamic change of an intraoperative stroke, which was preceded by a hypotensive episode and followed by sustained hypertension. The stroke was presented with decreased level of consciousness initially and confirmed by the brain CT, which revealed acute infarction at the right middle cerebral artery territory, four days after the procedure. Multiple mechanisms such as intraoperative hypotensive episode and vascular atherosclerotic change due to poor controlled diabetes mellitus might be involved in the event. In the meanwhile, hyperviscosity (3.7 centipoise units of the patient v.s. 1.4-1.8 centipoise units of normal range) caused by multiple myeloma might also have contributed to the intraoperative stroke. Clinical presentation of this case will be discussed.- - - - - - - - - - ranking = 2.1082078023396keywords = fracture (Clic here for more details about this article) |
10/88. A case of meningeal myeloma presenting as obstructive hydrocephalus--a therapeutic challenge.Meningeal involvement in myeloma is a rare though recognised complication, and previous treatment strategies have included radiotherapy, intra-thecal and systemic chemotherapy to which there is almost universally a poor response. We report a case of a 60-year-old lady in serological remission with IgG lambda myeloma, presenting with obstructive hydrocephalus due to meningeal infiltration treated with neurosurgical decompression. Such presentation and the treatment strategies are previously unreported, though in view of the ultimate resistance to treatment the prognosis remains poor.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
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