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Updated: Jun 2, 2026
Establishment of a Human Multiple Myeloma Xenograft Model in the Chicken to Study Tumor Growth, Invasion and Angiogenesis
Published on: May 1, 2015
Renal and Extramedullary Involvement Revealing Atypical Multiple Myeloma: A Case Report and a Literature Review
Zohra El Ati1, Asma Hadhri1, Rihem Dahmane2
1Department of Nephrology, University Hospital of Tahar Sfar Mahdia, Faculty of Medicine of Monastir, University of Monastir, Tunisia.
Background:
Multiple myeloma (MM) is a plasma cell malignancy with diverse clinical manifestations. Beyond the classic CRAB features (hypercalcemia, renal insufficiency, anemia, and lytic bone lesions), extramedullary involvement is rare and often life-threatening. This case highlighted atypical and severe pulmonary-pleural manifestations, emphasizing the diagnostic complexity of extramedullary disease.
Case Presentation:
A 67-year-old hypertensive man was admitted with fever, dyspnea, and hemoptysis. He presented with pleural effusion, biologically confirmed alveolar hemorrhage, nephrotic-range proteinuria, and osteolytic lesions. Cytology demonstrated pleural plasmacytic infiltration, and bone marrow aspiration showed 100% plasmacytosis. He was diagnosed with immunoglobulin G-kappa MM with pulmonary and pleural extramedullary disease and achieved partial remission with melphalan-dexamethasone, maintaining clinical improvement for 12 months.
Conclusion:
This case illustrated rare, severe extramedullary manifestations of MM with renal dysfunction as a key clinical clue. It underscored the importance of early recognition and comprehensive diagnostic evaluation. Prognosis remains poor in aggressive variants despite timely treatment.
