Mieloma multiplo: da plasmocitoma a coinvolgimento multiorgano

Multiple myeloma: from plasmacytoma to multi-organic involvement. Solitary plasmacytoma is a rare form of plasma cell dyscrasia characterized by localized proliferation of neoplasticmonoclonal plasmacells. The lesion can originate in bone or in soft tissue, with no or minimal evidence of bonemarrow plasmacytosis (<10%) and absence of end-organ damage signs such as hypercalcaemia, renal insufficiency,anaemia, or bone lesions (CRAB). We present a case of solitary bone plasmacytoma (SPB) that rapidly evolved tomultiple myeloma (MM). A partial response was obtained within few months of chemotherapy but then the diseaserapidly progressed with involvement of liver, kidneys and lungs. Salvage therapy (bendamustine-bortezomib-dexamethasone, 1 cycle) had no effect and the patient died shortly after. Biochemical work up plays a central role inthe follow up of MM patients, as recommended by international guidelines. In some cases the disease is soaggressive that early diagnosis and treatment fail to improve the outcome.