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Myeloma with predominant phalangeal involvement.
Nabeel Dastgir1, Gerry O'Dowd, Peter O'Rourke
1Department of Orthopaedic Surgery, Letterkenny General Hospital, Ireland. nabeel@esatclear.ie
Acta Orthopaedica Belgica
|April 2, 2004
Summary
This case report details a rare instance of non-secretory plasma cell myeloma affecting a finger bone. Early consideration of myeloma in hand bone lesions is crucial for accurate diagnosis.
Area of Science:
- Oncology
- Hematology
- Skeletal Pathology
Background:
- Plasma cell myeloma is a malignancy of plasma cells.
- Bone involvement is common in myeloma, but phalangeal lesions are exceptionally rare.
- Non-secretory myeloma lacks detectable monoclonal proteins in serum or urine.
Observation:
- A unique case of plasma cell myeloma involving the middle phalanx of the ring finger is presented.
- The myeloma was non-secretory, with monoclonal immunoglobulins identified only via immunohistochemistry.
- Radiological findings were consistent with myeloma.
Findings:
- This represents one of the few documented cases of plasma cell myeloma with phalangeal bone involvement.
- Immunohistochemical analysis confirmed the plasma cell origin despite the non-secretory nature.
- The rarity highlights the challenges in diagnosing extraskeletal myeloma presentations.
Implications:
- Plasma cell myeloma should be included in the differential diagnosis for bone lesions in the hand, even if seemingly unusual.
- Early recognition can improve patient outcomes by enabling timely and appropriate treatment.
- Further research into rare myeloma presentations is warranted to refine diagnostic criteria and treatment strategies.