Extramedullary Myeloma


 


Authored by Nahla A M Hamed
xtramedullary myeloma (EMM) is the presence of clonal plasma cells (PCs) outside the bone marrow in a patient with multiple myeloma (MM). EMM can be present at the time of initial diagnosis (primary EMM) or at the time of relapse (secondary EMM) [1]. EMM has an incidence of 7% to 20% at presentation and 6% to 20% during disease progression [2]. Using sensitive imaging techniques including MRI and PET/CT, EMM may be found in up to 30% of MM patients across the overall disease course [3]. Blade et al. [4] proposed two distinct mechanisms of EMM: direct extension of bone plasmacytomas with cortical destruction and hematogeneous dissemination of myeloma cells to an anatomical site distant from the bone marrow. Extramedullary spread can be triggered by an invasive procedure (surgery or catheter insertion) or by a bone fracture [3].
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