Abstract
BackgroundIgM multiple myeloma is rare disorder, which has clinical, laboratory and radiological manifestations that are consistent with both multiple myeloma and Waldenstrom's macroglobulinaemia.Case presentationAn 83 years Welsh lady presented with clinical and radiological features consistent with spinal cord compression. Further investigations confirmed the diagnosis of IgM multiple myeloma. Following localized radiotherapy and five courses of melphalan and prednisolone, the patient achieved partial remission of her myeloma. Later on, the patient had disease progression in the form of rising serum IgM level and the development of multiple plasmacytomas. She was treated with thalidomide, cyclophosphamide, dexamethasone and radiotherapy, which resulted in the control of her disease for one year. To our knowledge, this is the second case of IgM myeloma presenting with a plasmacytoma and the first case of IgM myeloma presenting with cord compression caused by plasmacytomas.ConclusionUnlike other types of multiple myeloma IgM myeloma is rarely complicated by plasmacytomas. However, spinal cord compression caused by plasmacytomas in this type of myeloma is extremely rare. Nevertheless, the same lines of management, e.g. cytotoxic chemotherapy and local radiotherapy that are applied to other types of myeloma can be successfully utilized.
Highlights
IgM multiple myeloma is rare disorder, which has clinical, laboratory and radiological manifestations that are consistent with both multiple myeloma and Waldenstrom's macroglobulinaemia.Case presentation: An 83 years Welsh lady presented with clinical and radiological features consistent with spinal cord compression
Unlike other types of multiple myeloma IgM myeloma is rarely complicated by plasmacytomas
Spinal cord compression caused by plasmacytomas in this type of myeloma is extremely rare
Summary
MM with IgM paraprotienaemia is a very rare disease, which can present as any other type of myeloma. It is a very rare disease that accounts for approximately 0.5 percent of all MMs. It is a very rare disease that accounts for approximately 0.5 percent of all MMs It usually presents with the same signs and symptoms as other types of myeloma and should be distinguished from WM based on clinical criteria, bone marrow morphology, immunophenotyping and cytogenetics as both disorders are different with respect to: modalities of treatment given, response to therapy and prognosis [5,6,7,8]. The malignant cells in IgM myeloma have a distinctive chromosomal translocation that differentiates
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