Relapsing Cutaneous Multiple Myeloma Responding to Immunochemotherapy: A Rare Case Report

Area of Science:

• Hematology
• Oncology
• Dermatology

Background:

• Multiple myeloma (MM) is a hematological malignancy involving plasma cell proliferation.
• Cutaneous MM is an extremely rare manifestation with a poor prognosis, often presenting as skin nodules or rash.
• Diagnosis is typically suspected based on clinical signs like hypercalcemia, renal failure, anemia, and M-spike proteins.

Observation:

• An 82-year-old male with a history of MM and prior treatments developed violaceous chest nodules.
• Biopsy confirmed cutaneous MM, and initial treatment with pomalidomide, panobinostat, and dexamethasone yielded a complete response.
• Recurrent skin nodules reappeared a year later, again diagnosed as MM via biopsy.

Findings:

• The patient achieved a complete response to daratumumab for recurrent cutaneous MM.
• This response occurred without the development of new M-spike proteins.
• The patient's lesions resolved, demonstrating efficacy of newer therapies against this rare condition.

Implications:

• This case underscores the potential for newer chemotherapies to effectively treat rare cutaneous manifestations of MM.
• It suggests that even with a poor prognosis, patients may experience significant benefit from advanced treatments.
• Further research into managing cutaneous MM is warranted, focusing on novel therapeutic strategies and outcomes.