小笠原　壽恵    Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine    Position   Assistant Professor
Language	Japanese
Title	Refractory multiple myeloma with multiple subcutaneous tumors and myelofibrosis at the time of diagnosis
Conference	The 83nd Annual Meeting of the Japanese Society of Hematology
Conference Type	Nationwide Conferences
Presentation Type	Poster notice
Lecture Type	General
Publisher and common publisher	Toshie Ogasawara, Shoko Marshall, Hiroshi Kazama Kiyotaka Kawauchi, Atsuko Masunaga, Hiroshi Sakura
Date	2020/10/10
Venue (city and name of the country)	kyokuto , Japan
Summary	Recently, the prognosis of multiple myeloma (MM) including overall survival has been improved with new drugs. On the other hand, although the incidence of primary extramedullary disease (EM) in MM was rare and estimated at 6-8%, effective treatment for EM are not yet established and the prognosis is poor. We report a 63 years-old man of MM who developed subcutaneous tumors. He presented with back pain and fever. CT scan revealed a subcutaneous tumor around the sternum, mediastinal lymphadenopathy, and pleural thickening with pleural effusion. Peripheral blood revealed a leukoerythroblastosis. Bone marrow biopsy showed fibrosis and infiltration of large or small atypical cells with high N/C ratio, which were positive for CD138 and cytoplasmic IgG/κimmunoglobulin. The biopsy of subcutaneous tumors showed an infiltration of atypical cells similar to that of bone marrow. He was diagnosed as having MM with primary EM and his disease was refractory to chemotherapy containing bortezomib resulted in a progression with multiple subcutaneous tumors. We discuss and review the primary EM including subcutaneous involvement.