Multiple myeloma with extramedullary plasmacytoma invading the skin and eyeballs following autologous stem cell transplantation: A case report

In this study, the case of a 60-year-old female patient who presented with a subcutaneous mass in the lower right limb is described. The mass was confirmed as a plasmacytoma. The patient was diagnosed with multiple myeloma (MM) λ type stage III international stage system (ISS) and received three cycles of a therapeutic PDT regimen (bortezomib, dexamethasone and thalidomide) and complete remission was achieved. Following a further two cycles of the PDT regimen, the patient proceeded to received a high-dose cyclophosphamide regimen combined with granulocyte-colony stimulating factor (G-CSF) for stem cell mobilization. Fourteen months later, the patient received a high-dose therapy supported by autologous stem cell transplantation (auto-SCT). After six months, a subcutaneous mass was identified in the left side of the patient’s neck and the mass gradually increased in size. The patient exhibited exophthalmos and loss of sight one month later. The masses in the neck and right eyelid of the patient were diagnosed as plasmacytomas. These results, combined with the results of bone marrow (BM) aspiration and protein electrophoresis with immunofixation electrophoresis revealed that the disease had relapsed. The patient received two cycles of a therapeutic CPADT regimen (cyclophosphamide, bortezomib, pharmorubicin, dexamethasone and thalidomide). The patient subsequently achieved complete remission again. The patient refused to continue receiving bortezomib and pharmorubicin for therapy and instead received four cycles of the therapeutic CTD regimen (cyclophosphamide, dexamethasone and thalidomide). Subsequently the patient received local radiotherapy for the masses in the eyes and neck. The patient remained stable after treatment following the initial relapse with a progression-free survival (PFS) time of eight months.