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Multiple myeloma involving the myocardium and coronary vessels
A L Champeaux1, J L Blaser, J B Myers
1Department of Pathology, Madigan Army Medical Center, Tacoma, WA 98431, USA.
Insights
This case study details metastatic plasmacytoma affecting the heart muscle and coronary arteries in a multiple myeloma patient. This rare cardiac involvement, previously undescribed in coronary vessels, highlights potential complications of advanced cancer.
Area of Science:
- Oncology
- Cardiology
- Pathology
Background:
- Multiple myeloma is a hematologic malignancy.
- Plasmacytomas are localized plasma cell tumors.
- Metastatic spread of plasmacytoma is uncommon.
Observation:
- A 57-year-old man with multiple myeloma presented with congestive heart failure symptoms.
- The patient had a history of chest wall and lung plasmacytoma treated with radiation and chemotherapy.
- No prior cardiac disease was noted.
Findings:
- Autopsy revealed metastatic plasmacytoma infiltrating the myocardium.
- The tumor externally compressed coronary arteries and infiltrated the coronary sinus.
- This represents a rare instance of cardiac and coronary vessel involvement by plasmacytoma.
Implications:
- This case highlights a previously undescribed pattern of plasmacytoma metastasis.
- Cardiac involvement may contribute to heart failure in advanced multiple myeloma.
- Further research is needed to understand the clinical significance and diagnostic challenges of cardiac plasmacytoma.
Abstract:
We report a case of metastatic plasmacytoma to the myocardium and coronary vessels in a 57-year-old man with multiple myeloma. Originally, the patient had a large plasmacytoma in his left chest wall and lung. He received local radiation and chemotherapy. Subsequently, the patient presented with symptoms of congestive heart failure. He had no prior history of cardiac disease. The patient was treated medically and later died from respiratory failure. At autopsy, a metastatic plasmacytoma was identified within the myocardium and externally compressing the coronary arteries. The tumor infiltrated into the coronary sinus. It is difficult to speculate whether the patient's symptoms were due to cardiac involvement since the tumor burden in his chest was also considerable. To our knowledge, coronary vessel involvement with plasmacytoma has not been previously described.