Lee SB, Park CY, Lee HJ, Hong R, Kim WS, Park SG. Non-secretory multiple myeloma expressed as multiple extramedullary plasmacytoma with an endobronchial lesion mimicking metastatic cancer: A case report. World J Clin Cases 2022; 10(22): 7899-7905 [PMID: 36158506 DOI: 10.12998/wjcc.v10.i22.7899]
Corresponding Author of This Article
Sang-Gon Park, MD, Assistant Professor, Department of hemato-oncology, Chosun Univ Hosp, 365 Pilmun-daero, Dong-gu, Gwangju 501-717, South Korea. sgpark@chosun.ac.kr
Research Domain of This Article
Hematology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2022; 10(22): 7899-7905 Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7899
Non-secretory multiple myeloma expressed as multiple extramedullary plasmacytoma with an endobronchial lesion mimicking metastatic cancer: A case report
Seul Bi Lee, Chi Young Park, Hee Jeong Lee, Ran Hong, Woo Shin Kim, Sang-Gon Park
Seul Bi Lee, Chi Young Park, Hee Jeong Lee, Sang-Gon Park, Department of Hemato-oncology, Chosun University Hospital, Gwangju 501-717, South Korea
Ran Hong, Department of Pathology, Chosun University Hospital, Gwangju 501-717, South Korea
Woo Shin Kim, Department of Laboratory Medicine, Chosun University Hospital, Gwangju 501-717, South Korea
Author contributions: Lee SB were the major contributors in writing the manuscript; Park CY, Lee HJ, Hong R, and Kim WS advised the manuscript; Park SG were involved in drafting, writing and editing the manuscript, and reviewed the manuscript as corresponding author; all authors read and approved the final manuscript.
Supported bythe Clinical Medicine Research Institute at Chosun University Hospital (2019).
Informed consent statement: All study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sang-Gon Park, MD, Assistant Professor, Department of hemato-oncology, Chosun Univ Hosp, 365 Pilmun-daero, Dong-gu, Gwangju 501-717, South Korea. sgpark@chosun.ac.kr
Received: August 24, 2021 Peer-review started: August 24, 2021 First decision: November 17, 2021 Revised: November 26, 2021 Accepted: June 24, 2022 Article in press: June 24, 2022 Published online: August 6, 2022 Processing time: 332 Days and 2 Hours
Abstract
BACKGROUND
Non-secretory multiple myeloma (MM) is a rare condition that accounts for only 3% of MM cases and is defined by normal serum and urine immunofixation and a normal serum free light chain ratio. Non-secretory MM with multiple extramedullary plasmacytomas derived from endobronchial lesions is extremely rare and can be misdiagnosed as metastasis of solid cancer.
CASE SUMMARY
A 36-year-old man presented with progressive facial swelling and nasal congestion with cough. Various imaging studies revealed an endobronchial mass in the left bronchus and a large left maxillary mass with multiple destructive bone metastatic lesions. He initially presented with lung cancer and multiple metastases. However, pathologic reports showed multiple extramedullary plasmacytomas in the left maxilla and the left bronchus. There was no change in the serum and urine monoclonal protein levels, and no abnormalities were observed in laboratory examinations, including hemoglobin, calcium, and creatinine levels. The bone marrow was hypercellular, with 13.49% plasma cells. The patient was diagnosed with non-secretory MM expressed as multiple extramedullary plasmacytomas with endobronchial lesions in a rare location. Radiation therapy for symptomatic lesions with high-dose dexamethasone was started, and the size of the left maxillary sinus lesion dramatically decreased. In the future, chemotherapy will be administered to control lesions in other areas.
CONCLUSION
We present a rare case of non-secretory MM with multiple extramedullary plasmacytoma with an endobronchial lesion.
Core Tip: Endobronchial and maxillary mass lesions without abnormality on laboratory examination are easily misdiagnosed as metastases of primary lung cancer or other head and neck malignancies. Histopathological studies are required to avoid erroneous diagnoses.
