Cargando…

Massive limb lymphedema as the initial presentation of multiple myeloma: a case report

Multiple myeloma is a malignant neoplasm of plasma cells that primarily causes bone destruction and marrow failure. We report a female patient who presented with limb lymphedema as the first manifestation of multiple myeloma. According to guideline of the International Myeloma Working Group, this pa...

Descripción completa

Detalles Bibliográficos
Autores principales: Yang, Chunmei, You, Liangshun, Meng, Haitao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797955/
https://www.ncbi.nlm.nih.gov/pubmed/35116485
http://dx.doi.org/10.21037/tcr-20-3143
_version_ 1784641678120845312
author Yang, Chunmei
You, Liangshun
Meng, Haitao
author_facet Yang, Chunmei
You, Liangshun
Meng, Haitao
author_sort Yang, Chunmei
collection PubMed
description Multiple myeloma is a malignant neoplasm of plasma cells that primarily causes bone destruction and marrow failure. We report a female patient who presented with limb lymphedema as the first manifestation of multiple myeloma. According to guideline of the International Myeloma Working Group, this patient was diagnosed as symptomatic IgG lambda MM (Durie-Salmon stage II and International System Stage II) based on the detected values of an M-protein in the serum, clonal bone marrow plasma cells > 10% and anemia. Lymphedema was divided into primary and secondary. The most common secondary factor is malignant tumor, especially breast cancer. We excluded other causes and found no other contributing factors to the patient’s massive limb lymphedema apart from multiple myeloma. After one cycle of bortezomib-based chemotherapy, the patient’s lymphedema began to resolve and almost completely disappeared after 4 months. As far as we know, this is the first reported case of multiple myeloma patient who developed massive lymphedema. NF-κB signaling pathway is the main pathogenesis of multiple myeloma, and closely related with the development of lymphedema. More importantly, the symptom of lymphedema relieved after the treatment of NF-κB inhibitor Bortezomib in this patient. Based on the findings of the present study, as well as those of the literature, we proposed NF-κB may play an important role in the development of the patient’s lymphedema. Further studies are warranted to explain the underlying mechanisms. But this case indicated multiple myeloma may present atypically. We should further examine and clarify the secondary factors of lymphedema, in order to early diagnosis and treatment.
format Online
Article
Text
id pubmed-8797955
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher AME Publishing Company
record_format MEDLINE/PubMed
spelling pubmed-87979552022-02-02 Massive limb lymphedema as the initial presentation of multiple myeloma: a case report Yang, Chunmei You, Liangshun Meng, Haitao Transl Cancer Res Case Report Multiple myeloma is a malignant neoplasm of plasma cells that primarily causes bone destruction and marrow failure. We report a female patient who presented with limb lymphedema as the first manifestation of multiple myeloma. According to guideline of the International Myeloma Working Group, this patient was diagnosed as symptomatic IgG lambda MM (Durie-Salmon stage II and International System Stage II) based on the detected values of an M-protein in the serum, clonal bone marrow plasma cells > 10% and anemia. Lymphedema was divided into primary and secondary. The most common secondary factor is malignant tumor, especially breast cancer. We excluded other causes and found no other contributing factors to the patient’s massive limb lymphedema apart from multiple myeloma. After one cycle of bortezomib-based chemotherapy, the patient’s lymphedema began to resolve and almost completely disappeared after 4 months. As far as we know, this is the first reported case of multiple myeloma patient who developed massive lymphedema. NF-κB signaling pathway is the main pathogenesis of multiple myeloma, and closely related with the development of lymphedema. More importantly, the symptom of lymphedema relieved after the treatment of NF-κB inhibitor Bortezomib in this patient. Based on the findings of the present study, as well as those of the literature, we proposed NF-κB may play an important role in the development of the patient’s lymphedema. Further studies are warranted to explain the underlying mechanisms. But this case indicated multiple myeloma may present atypically. We should further examine and clarify the secondary factors of lymphedema, in order to early diagnosis and treatment. AME Publishing Company 2021-03 /pmc/articles/PMC8797955/ /pubmed/35116485 http://dx.doi.org/10.21037/tcr-20-3143 Text en 2021 Translational Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle Case Report
Yang, Chunmei
You, Liangshun
Meng, Haitao
Massive limb lymphedema as the initial presentation of multiple myeloma: a case report
title Massive limb lymphedema as the initial presentation of multiple myeloma: a case report
title_full Massive limb lymphedema as the initial presentation of multiple myeloma: a case report
title_fullStr Massive limb lymphedema as the initial presentation of multiple myeloma: a case report
title_full_unstemmed Massive limb lymphedema as the initial presentation of multiple myeloma: a case report
title_short Massive limb lymphedema as the initial presentation of multiple myeloma: a case report
title_sort massive limb lymphedema as the initial presentation of multiple myeloma: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797955/
https://www.ncbi.nlm.nih.gov/pubmed/35116485
http://dx.doi.org/10.21037/tcr-20-3143
work_keys_str_mv AT yangchunmei massivelimblymphedemaastheinitialpresentationofmultiplemyelomaacasereport
AT youliangshun massivelimblymphedemaastheinitialpresentationofmultiplemyelomaacasereport
AT menghaitao massivelimblymphedemaastheinitialpresentationofmultiplemyelomaacasereport