, Volume 87, Issue 12, pp 1027-1029
Date: 25 Jun 2008

Breast and pelvic masses in a myeloma patient

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Dear Editor,

A 52-year-old mentally retarded woman initially presented with hypercalcemia (adjusted calcium level 3.11 mmol/L) and anemia (hemoglobin level 8.3g/dL) in April 2006. Upon presentation, she had elevated IgG (7410 mg/dL) with immunoparesis, i.e., decreased IgM (30 mg/dL) and IgA (12 mg/dL) levels. An IgG lambda paraprotein of 42.9 g/L was detected by serum protein electrophoresis. Bone marrow was nearly completely replaced by CD 138 positive plasma cells. Skeletal survey revealed generalized osteopenia with multiple lytic lesions in the ribs. She was thus diagnosed to have international staging system stage 2 multiple myeloma and was treated with combination of mephalan, thalidomide, and prednisolone as well as regular zoledronic acid infusion. Initially, she had a significant reduction in paraprotein level from 42.9 g/L to 23.6 g/L. However, her calcium level remained persistently elevated (>3.0 mmol/L). Her renal function had been normal and she was asymptomatic despite th ...