An Unusual Case of Multiple Myeloma with Light-Chain Cast Nephropathy Secondary to a Very Large Plasmacytoma without Bone Marrow Involvement

Justin Komisarof; Jodi Lipof; Joseph DiTursi; Amit Chowdhry; Hae Yoon Grace Choung; W Richard Burack; Louis Constine; Frank Passero

doi:10.1155/2022/7531142

An Unusual Case of Multiple Myeloma with Light-Chain Cast Nephropathy Secondary to a Very Large Plasmacytoma without Bone Marrow Involvement

Case Rep Hematol. 2022 Feb 21:2022:7531142. doi: 10.1155/2022/7531142. eCollection 2022.

Authors

Justin Komisarof¹, Jodi Lipof², Joseph DiTursi¹, Amit Chowdhry³, Hae Yoon Grace Choung⁴, W Richard Burack⁴, Louis Constine³, Frank Passero²

Affiliations

¹ Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
² Department of Hematology and Oncology, Wilmot Cancer Institute, 601 Elmwood Avenue, Rochester, NY 14642, USA.
³ Department of Radiation Oncology, Wilmot Cancer Institute, 601 Elmwood Avenue, Rochester, NY 14642, USA.
⁴ Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.

Abstract

Here, we report a case of a patient who presented to Strong Memorial Hospital with new-onset renal failure and anemia and was found to have multiple myeloma with lambda light-chain cast nephropathy secondary to a very large (14 cm × 14 cm × 12 cm) plasmacytoma without bone marrow involvement. This case is notable as solitary plasmacytomas are almost never seen with concomitant myeloma-defining CRAB criteria or significantly elevated serum free light-chain ratios. Although solitary plasmacytomas are typically definitively treated with radiation, this case highlights that systemic treatment may be helpful in certain clinical scenarios.

Publication types

Case Reports