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Submitted: July 12, 2021 | Approved: July 20, 2021 | Published: July 21, 2021

How to cite this article: Rieu JP, Vergez F, Corre J, Perrot A, Mouchel PL. Atypical cutaneous relapse of multiple myeloma. J Clin Med Exp Images. 2021; 5: 006-006.

DOI: 10.29328/journal.jcmei.1001022

Copyright: © 2021 Rieu JP, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Atypical cutaneous relapse of multiple myeloma

Jean-Baptiste Rieu1*, Francois Vergez1, Jill Corre1, Aurore Perrot2 and Pierre-Luc Mouchel2

1Haematology Laboratory, University Institute Cancer Toulouse Oncopole, France 2Clinical Haematology Department, University Institute Cancer Toulouse Oncopole, France

*Address for Correspondence: Dr. Jean-Baptiste Rieu, Haematology Laboratory, University Institute Cancer Toulouse Oncopole, France, Email: rieu.jeanbaptiste@iuct-oncopole.fr

 

A 66-year-old patient, diagnosed κ light chains MM with t(11;14), presented before second cycle with bendamustine-dexamethasone. A complete remission was initially obtained with bortezomib-cyclophosphamide-dexamethasone and autologous HSCT. After relapse, he was successively treated with bortezomib-dexamethasone, carfilzomib-dexamethasone, daratumumab-dexamethasone and benda-mustine-dexamethasone. SFLC measurement indicated a partial response but clinical examination revealed a soft pink skin lesion of four centimeters on the left side of the abdomen (A). Puncture of this lesion showed an infiltration of dystrophic plasma cells, with high nucleus-cytoplasm ratio and immature chromatin (B, May-Grünwald-Giemsa, objective × 100) (Figure 1). Flow cytometry and genetic analysis con-firmed monotypic κ plasma cells with t(11;14). External beam radiation therapy was a partial failure and bone plasmocytomas appeared two month later.

Cutaneous plasmocytoma in the setting of an established MM is very rare but associated with a poor prognosis. Venetoclax monotherapy was initiated but the general health of the patient declined dramatically before the initiation of the treatment.


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Figure 1: A,B