Relapsed Extramedullary Multiple Myeloma Presenting as Bilateral Solid Perirenal Masses.

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• IgA myeloma is a plasma cell malignancy.
• Treatment often involves chemotherapy, radiation, and stem cell transplantation.
• Extramedullary disease can occur in multiple myeloma.

Observation:

• A patient with IgA myeloma initially responded to chemo-radiation therapy.
• The patient underwent autologous and nonmyeloablative allogeneic bone marrow transplantation.
• Relapse occurred after six years with extensive bilateral perirenal extramedullary disease.

Findings:

• The relapse presented with unusual and extensive extramedullary disease.
• Perirenal involvement was a significant feature of the relapse.
• Myeloma expression at relapse was highly variable.

Implications:

• Individualized patient follow-up is essential for managing myeloma.
• Periodic imaging is critical for the early detection of myeloma relapse.
• Understanding variable relapse patterns can inform treatment strategies.