Unusual localisation of amyloid deposits in plasma cell myeloma

Abstract

Amyloid deposits in the lower lip were found in a 68-year-old patient with plasma cell myeloma (PCM) (variant: κ light chain disease), leukopenia and coexisting ischemic heart disease four years since the diagnosis of malignancy. The lesion was surgically removed. Inaccessibility of proteasome inhibitors resulted that the patient was treated mainly with cyclophosphamide and dexamethasone. This systemic treatment resulted in partial remission and stabilization of PCM. During further observation the patient experienced severe exacerbation of his ischemic heart disease, heart infarct and severe heart failure as well as PCM progression. Surgical treatment of amyloid tumor was complicated by impaired lip healing. This case indicates that tumors containing amyloid deposits in unusual localisation are likely to occur in the course of PCM.