Multiple myeloma disease with a extramedullary plasmacytoma in breast: A case report

CONTEXT: the most common malignancy of plasma cell is multiple myeloma (MM) in which malignant neoplasms termed plasmacytoma spread in the bone marrow and the incidence of extramedullary plasmacytoma especially in smooth tissues such as breast is rare. Case report: Here, we describe a 39-year-old female case with MM which in capillary Serum protein electrophoresis showed an increase in the amount of gamma globulin (3.6 g/dl) and beta-2 micro globulin (5.33 mg/dl) with no reduction in protein Bence Jones, as well bone marrow aspiration showed 22% plasma cell and Iliac crest biopsy confirmed the presence of multiple myeloma, Skull radiography Revealed osteolyticlesions. Reports obtained from flow cytometry and cytogenetic tests showed that CD56 increased as a marker of plasma cells and no amplification or deletion were found in 11q23, 13q14.3, 6q21, 19q13 and 17p53, while Fluorescence in situ hybridization (FISH) detected a rearrangement of IGH gene in t(14q32). Patient treated initially with chemotherapy: VAD (vincristine, adriamycin, dexamethasone) and went to remission but one week before the bone marrow transplantation, patient referred with a mobile and solid mass in upper part of the right breast. Mammography showed a well circumscribed dens nodule, fine needle aspiration (FNA) cytology was unsatisfactory and core biopsy revealed a extramedullary plasmacytoma. Disease progressed rapidly and she should be treated by radiotherapy. Conclusion: since myeloma origin of the metastatic tumor in the breast, it may be found that factors such as age, gender, treatment regimen and suchlike might be regarded in future therapy studies.

Keywords:

multiple myeloma , plasmacytoma extramedullary , breast , metastasis