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Rare Association between Sarcoidosis and Smoldering Multiple Myeloma: A Case Report
Brooke N Learned1, Wazhma Nasiri-Ahad2, James E Davis3
1Department of Medicine, Stony Brook Medicine, Stony Brook, New York, USA.
Cancer Investigation
|October 4, 2021
Summary
This case highlights the simultaneous diagnosis of sarcoidosis and smoldering multiple myeloma (SMM), emphasizing diagnostic challenges in hypercalcemic patients. Early identification of both conditions is crucial for effective management.
Area of Science:
- Hematology
- Pulmonology
- Oncology
Background:
- Sarcoidosis and multiple myeloma (MM) have been anecdotally linked, but concurrent smoldering MM (SMM) is rare.
- Hypercalcemia can be a presenting symptom for both sarcoidosis and multiple myeloma.
Observation:
- A patient presented with hypercalcemia, prompting investigations for both sarcoidosis and MM.
- Invasive testing, including surgical lung biopsy and bone marrow biopsy, was required for definitive diagnosis.
Findings:
- Surgical lung biopsy showed necrotizing granulomas consistent with sarcoidosis after excluding infection.
- Bone marrow biopsy revealed 13% plasma cells, confirming the diagnosis of smoldering multiple myeloma.
Implications:
- This case underscores the diagnostic complexities when sarcoidosis and SMM coexist.
- It highlights the importance of thorough investigation to differentiate CRAB symptoms in patients with potential co-occurring conditions.
