English 
Italian CASI CLINICI – Case Reports
Volume:
Biochimica Clinica 2020; 44(2) E16-E19
Pubblicato on-line:
April 15, 2020
DOI:
10.19186/BC_2020.029
Mieloma multiplo: da plasmocitoma a coinvolgimento multiorgano
Multiple myeloma: from plasmacytoma to multi-organic involvement
AUTORI
1Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università Federico II, Napoli
2Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, Napoli
3Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli
4UOC Ematologia e Trapianti di Midollo, AOU Federico II, Napoli
5DAI Medicina di Laboratorio e Trasfusionale, AOU Federico II, Napoli
ABSTRACT
Multiple myeloma: from plasmacytoma to multi-organic involvement.
Solitary plasmacytoma is a rare form of plasma cell dyscrasia characterized by localized proliferation of neoplastic monoclonal plasmacells. The lesion can originate in bone or in soft tissue, with no or minimal evidence of bone marrow plasmacytosis (<10%) and absence of end-organ damage signs such as hypercalcaemia, renal insufficiency, anaemia, or bone lesions (CRAB). We present a case of solitary bone plasmacytoma (SPB) that rapidly evolved to multiple myeloma (MM). A partial response was obtained within few months of chemotherapy but then the disease rapidly progressed with involvement of liver, kidneys and lungs. Salvage therapy (bendamustine-bortezomib-dexamethasone, 1 cycle) had no effect and the patient died shortly after. Biochemical work up plays a central role in the follow up of MM patients, as recommended by international guidelines. In some cases the disease is so aggressive that early diagnosis and treatment fail to improve the outcome.