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July 6, 1979

Extramedullary Myeloma With Metastatic Features

Author Affiliations

From the Department of Medicine, Hematology-Lymphoma Service, Memorial Sloan-Kettering Cancer Center, New York. Dr Schulman is now with the Division of Oncology, Department of Medicine, North Shore University Hospital, Manhasset, NY, Cornell University Medical College, New York.

JAMA. 1979;242(1):65. doi:10.1001/jama.1979.03300010049029

MULTIPLE myeloma is a disease mostly confined to medullary sites, but may have varied extraosseous manifestations.1,2

Most commonly, these extraosseous lesions occur in the nasopharynax.3 The occurrence of extramedullary plasmacytoma in the retroperitoneum is rare, although isolated cases have been reported.1 Recently, we have had the opportunity to study a patient who initially had a case of combined myelomatosis with extramedullary subcutaneous lesions and who, at relapse, was found to have a huge retroperitoneal mass. This patient responded to pyrazofurin after treatment with nine other chemotherapeutic agents failed. These findings have recently been corroborated.4

Report of a Case  A 66-year-old woman had multiple lytic bone lesions, a large (6×10-cm), subcutaneous, biopsy-proved plasmacytoma of the right posterior area of her rib cage, bone marrow infiltration with 40% immature plasma cells, free k-chains in her urine, and a serum protein electrophoresis pattern with an IgG k-paraprotein spike of