Aggressive phase multiple myeloma with post-renal acute renal failure due to multiple extramedullary plasmacytomas

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  • TERASAKI Yasushi
    Division of Internal Medicine, Toyama City Hospital
  • OKUMURA Hirokazu
    Department of Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science
  • SAKAI Satoko
    Division of Internal Medicine, Toyama City Hospital
  • ISHIURA Yoshihisa
    Division of Internal Medicine, Toyama City Hospital
  • YOKAWA Shigeru
    Division of Internal Medicine, Toyama City Hospital
  • WATANABE Hideto
    Division of Internal Medicine, Toyama City Hospital
  • SAITO Katsuhiko
    Division of Pathology, Toyama City Hospital
  • OHATA Masahiko
    Department of Clinical Laboratory, Shizuoka Red Cross Hospital Department of General Medicine, Nara Medical University
  • NAKAO Shinji
    Department of Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science

Bibliographic Information

Other Title
  • 髄外性病変により腎後性腎不全を合併した劇症型多発性骨髄腫
  • 症例報告 髄外性病変により腎後性腎不全を合併した劇症型多発性骨髄腫
  • ショウレイ ホウコク ズイガイセイ ビョウヘン ニ ヨリ ジンゴセイ ジンフゼン オ ガッペイシタ ゲキショウガタ タハツセイ コツズイシュ

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Abstract

A 63-year-old woman was diagnosed as having multiple myeloma (MM), IgG-κ type, stage IIIA, in October 2003. She achieved partial response after receiving three courses of VAD therapy and one course of high dose dexamethasone therapy (HDD); maintenance therapy consisted of melphalan and prednisolone. In November 2004, the patient developed spinal canal stenosis that required surgery. At the end of December 2004, the patient developed renal dysfunction that progressed to anuria. A CT scan showed multiple retroperitoneal masses that impinged on and obstructed both ureters and caused bilateral hydronephroses. Renal function improved after a right percutaneous nephrostomy and chemotherapy consisting of HDD, cyclophosphamide, vincristine, and doxorubicin. Nevertheless, the patient died due to MM in February 2005. On autopsy, multiple retroperitoneal and pelvic plasmacytomas with 13q- and t(4;14) (p16;q32) were found. Our patient is a rare case that, in the terminal stage of MM, developed aggressive phase multiple myeloma with extramedullary plasmacytomas that caused acute renal failure due to compression on both ureters.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 48 (7), 565-570, 2007

    The Japanese Society of Hematology

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