Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7899
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
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 extra
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.
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.