Multiple Myeloma: A Rare Presentation As Unilateral Pleural Effusion

Area of Science:

• Hematology
• Oncology
• Pulmonology

Background:

• Multiple myeloma (MM) is a cancer of plasma cells, typically affecting the bone marrow.
• Common MM symptoms include bone pain, anemia, kidney problems, and high calcium levels.
• Pleural effusion, fluid around the lungs, is a known complication of MM, but rarely caused by direct tumor spread to the pleura.

Observation:

• A patient presented with cough, breathlessness, and weakness, unusual symptoms for typical MM.
• Diagnostic workup revealed the cause to be myelomatous pleural effusion (MPE), a rare manifestation of MM.
• This case underscores the importance of considering MPE in MM patients with atypical respiratory symptoms.

Findings:

• Myelomatous pleural effusion (MPE) is an uncommon cause of pleural effusion in multiple myeloma patients.
• The presence of MPE signifies a more advanced stage and poorer prognosis for multiple myeloma.
• Atypical presentations of MM, like respiratory symptoms due to MPE, necessitate a broad differential diagnosis.

Implications:

• Recognizing MPE in atypical presentations can lead to earlier MM diagnosis.
• Prompt identification of MPE allows for timely and appropriate MM treatment strategies.
• This case highlights the need for increased awareness of rare MM complications among clinicians.