open access

Vol 17, No 5 (2021)
Case report
Early publication date: 2021-10-25
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Development of second primary multiple myeloma five years after treatment for limited-stage small cell lung cancer: a rare case report

Melek Karakurt Eryılmaz1, Talat Aykut2, Mustafa Korkmaz1, Mustafa Karaağaç1, Murat Araz1, Mehmet Artaç1
DOI: 10.5603/OCP.2021.0030
·
Oncol Clin Pract 2021;17(5):232-235.
Affiliations
  1. Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Konya, Turkey
  2. Department of Internal Medicine, Necmettin Erbakan University School of Medicine, Konya, Turkey

open access

Vol 17, No 5 (2021)
CASE REPORTS
Early publication date: 2021-10-25

Abstract

Introduction. The development of a second primary malignancy (SPM) following small cell lung cancer (SCLC) has been previously reported in the literature. Especially smoking-related malignancy coupling is well known. The development of multiple myeloma (MM) in long-term survivors after treatment for SCLC is unknown. Here, we report the first case in the literature who developed MM 5 years after treatment for limited-stage SCLC.

Case report. A 67-year-old male patient was diagnosed with limited-stage SCLC. After he received chemotherapy and radiotherapy, he was followed up without medication. He was admitted to the hospital with back pain and dyspnea 5 years after the diagnosis of small cell lung cancer. MRI revealed osteolytic lesions in the vertebrae. Laboratory testing revealed a markedly elevated serum IgA and an elevated serum beta-2 microglobulin level. Serum immunofixation revealed IgA lambda-type M-protein. Lambda excretion in urine immunofixation electrophoresis was observed. Bone marrow aspiration revealed the frequency of plasma cells to be 80% of all nucleated cells. Hence, the final diagnosis revealed IgA lambda free light chain MM. Treatment was given for multiple myeloma. In the follow-up, the patient experienced increased dyspnea and developed bilateral pleural effusion. The cytology sent from thoracentesis sampling was reported as plasmocyte-rich material. The patient fell into a coma and died in an intensive care unit.

Conclusion. We presented the development of MM 5 years after treatment in a patient with SCLC who were treated for one year and then followed up with stable findings. It should be kept in mind that a patient with SCLC who is a long-term survivor and presents with back pain may have developed a primary malignancy originating from bone marrow rather than a bone metastasis. Patients should be advised smoking cessation after the treatment and diagnosis of SCLC. Also, the patients with SCLC who are long-term survivors should be closely monitored for the development of SPM.

Abstract

Introduction. The development of a second primary malignancy (SPM) following small cell lung cancer (SCLC) has been previously reported in the literature. Especially smoking-related malignancy coupling is well known. The development of multiple myeloma (MM) in long-term survivors after treatment for SCLC is unknown. Here, we report the first case in the literature who developed MM 5 years after treatment for limited-stage SCLC.

Case report. A 67-year-old male patient was diagnosed with limited-stage SCLC. After he received chemotherapy and radiotherapy, he was followed up without medication. He was admitted to the hospital with back pain and dyspnea 5 years after the diagnosis of small cell lung cancer. MRI revealed osteolytic lesions in the vertebrae. Laboratory testing revealed a markedly elevated serum IgA and an elevated serum beta-2 microglobulin level. Serum immunofixation revealed IgA lambda-type M-protein. Lambda excretion in urine immunofixation electrophoresis was observed. Bone marrow aspiration revealed the frequency of plasma cells to be 80% of all nucleated cells. Hence, the final diagnosis revealed IgA lambda free light chain MM. Treatment was given for multiple myeloma. In the follow-up, the patient experienced increased dyspnea and developed bilateral pleural effusion. The cytology sent from thoracentesis sampling was reported as plasmocyte-rich material. The patient fell into a coma and died in an intensive care unit.

Conclusion. We presented the development of MM 5 years after treatment in a patient with SCLC who were treated for one year and then followed up with stable findings. It should be kept in mind that a patient with SCLC who is a long-term survivor and presents with back pain may have developed a primary malignancy originating from bone marrow rather than a bone metastasis. Patients should be advised smoking cessation after the treatment and diagnosis of SCLC. Also, the patients with SCLC who are long-term survivors should be closely monitored for the development of SPM.

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Keywords

small cell lung cancer; multiple myeloma; second primary malignancy

About this article
Title

Development of second primary multiple myeloma five years after treatment for limited-stage small cell lung cancer: a rare case report

Journal

Oncology in Clinical Practice

Issue

Vol 17, No 5 (2021)

Article type

Case report

Pages

232-235

Early publication date

2021-10-25

DOI

10.5603/OCP.2021.0030

Bibliographic record

Oncol Clin Pract 2021;17(5):232-235.

Keywords

small cell lung cancer
multiple myeloma
second primary malignancy

Authors

Melek Karakurt Eryılmaz
Talat Aykut
Mustafa Korkmaz
Mustafa Karaağaç
Murat Araz
Mehmet Artaç

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