Multiple Myeloma - Atypical Presentation - Clinicopathological Correlation

BACKGROUND Multiple myeloma, malignant neoplasm of plasma cells producing monoclonal para protein is one of the most common haematological malignancies we see in our routine practice. Multiple myeloma has varied and diverse clinical presentations, of which most common clinical features will be anaemia, bone pain, fever, fatigue, weight loss, paraesthesia, renal failure, pathological fractures, cutaneous lesions, etc. We hereby, present a series of multiple myeloma cases with unusual presentation over a period of 3 years. The purpose of the study was to evaluate the unusual and rare clinicohaematological presentation in patients with multiple myeloma. METHODS In this case series study, we reviewed bone marrow aspirate & / or biopsy slides in our hospital from January 2017 to January 2020. Patients diagnosed with multiple myeloma were selected. Patients’ clinical information, haematological and other findings were obtained from the medical records department and compiled, and correlation was done. RESULTS We came across a total of 9 cases of multiple myeloma with very unusual and rare clinical presentations. A thorough clinical, radiological, haematological, biochemical and histopathological correlation was done before giving a final diagnosis in these cases. Rare cutaneous and other involvement of multiple myeloma was noted. CONCLUSIONS Multiple myeloma is the most common malignancy with comparatively poor prognosis. However, early diagnosis of multiple myeloma always helps the clinician in improving the outcome and has been shown to have better prognosis. The present case series is an attempt to understand the clinico-pathological correlation, wide spectrum of clinical presentation and associated rarity of presentations. KEY WORDS Myeloma; Lytic Lesions; Bone Marrow