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Article
October 1993

Subcutaneous Masses With Multiple Myeloma

Author Affiliations

Veterans Administration Medical Center and Medical College of Georgia, Augusta

Arch Dermatol. 1993;129(10):1335-1336. doi:10.1001/archderm.1993.01680310105021
Abstract

REPORT OF A CASE  A 57-year-old white man was diagnosed in May 1989 with IgG-κ multiple myeloma after presenting with lytic lesions of the skull, femurs, and several thoracic vertebrae. The initial serum M protein level was 48 g/L. He was treated initially with the SWOG protocol, which includes vincristine, carmustine, adriamycin, melphalan, cyclophosphamide, and prednisone.In November 1989, a subcutaneous, freely movable submental mass developed just left of the midline (Figure 1). The mass enlarged rapidly and became painful. Representative sections of a fine-needle aspiration are shown in Figure 2.What is your diagnosis?

DIAGNOSIS:  Cutaneous extramedullary plasmacytoma.

HISTOPATHOLOGIC FINDINGS  Numerous malignant plasma cells are seen.

CLINICAL COURSE  The patient received x-rays (20 Gy) to the neck with excellent response. However, over the next few months, new lesions developed involving the head, trunk, left arm, and groin (Figure 3). Again, fine-needle aspiration was consistent with

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