Multiple Myeloma in a Young Female Presenting with Neurological Symptoms

Matthew Lee; Xinmin Zhang; Vinh Nguyen; Monique Hartley-Brown

doi:10.1155/2020/1375174

Multiple Myeloma in a Young Female Presenting with Neurological Symptoms

Case Rep Hematol. 2020 Feb 13:2020:1375174. doi: 10.1155/2020/1375174. eCollection 2020.

Authors

Matthew Lee¹, Xinmin Zhang², Vinh Nguyen³, Monique Hartley-Brown⁴

Affiliations

¹ Internal Medicine Resident, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Dr, Manhasset, NY 11030, USA.
² Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Pathology Department at North Shore University Hospital-Long Island Jewish Medical Center, 300 Community Dr, Manhasset, NY 11030, USA.
³ Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Radiology Department at North Shore University Hospital-Long Island Jewish Medical Center, 300 Community Dr, Manhasset, NY 11030, USA.
⁴ Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hematology-Oncology Department at North Shore University Hospital-Long Island Jewish Medical Center, 300 Community Dr, Manhasset, NY 11030, USA.

Abstract

Background: Multiple myeloma is overall the 14^th most common malignancy but is rarely seen in those younger than 35 years. Those in the younger age group have been shown to have a more aggressive course but reportedly have had similar responses to treatment compared to older cohorts. Extramedullary plasmacytomas are discrete soft tissue masses of neoplastic monoclonal plasma cells that often occur in patients with multiple myeloma.

Case: This case entails a young female with new diagnosis of multiple myeloma and multiple extramedullary plasmacytomas presenting with neurological symptoms. She was treated with CyBorD regimen but was refractory and progressed. Treatment was changed to DCEP regimen, and daratumumab was added for primary refractory myeloma. The patient improved rapidly.

Conclusion: This is a unique case of multiple myeloma in a young female that had failed first-line treatment but responded to targeted therapy of daratumumab. It highlights that multiple myeloma may present atypically in young patients. More research is needed on appropriate initial diagnosis and treatment of patients in this age group.

Publication types

Case Reports