Eastern J Med. 2022; 27(2): 330-332 | DOI: 10.5505/ejm.2022.02259

Successful Treatment Of Bulky Abdominal Plasmacytomas With Radiotherapy and Pomalidomide

Ceren Barlas¹, Meltem Daðdelen¹, Tuðrul Elverdi², Ayþe Salihoðlu², Fazilet Öner Dinçbaþ^1
1Department of Radiation Oncology, Istanbul University- Cerrahpaþa, Cerrahpaþa Medical Faculty, Istanbul, Turkey
²Department of Internal Medicine (Hematology), Istanbul University- Cerrahpaþa, Cerrahpaþa Medical Faculty, Istanbul, Turkey

Extramedullary myeloma itself is a rare entity and treatment of recurrent extraosseous myeloma can be challenging during the prolonged disease course. We report a multiple myeloma(MM) patient with extramedullary bulky abdominal masses treated with palliative radiotherapy(RT) and concomitant pomalidomide.
A 59-year-old woman diagnosed with MM presented with pancytopenia, widespread lytic bone lesions and intraperitoneal implants.The patient received multiple series of chemotherapy.Following autologous stem cell transplantation(ASCT), imaging studies displayed bulky abdominal masses. Due to the rapidly progressing symptoms, palliative RT 30 Gy in 15 fractions with concomitant pomalidomide was administered.Post-RT imagings showed near-complete regression.
Extraosseous extramedullary MM has a poor prognosis and is an area of unmet clinical needs.Our report describes the treatment of a relapsed extramedullary myeloma case with RT and concomitant pomalidomide resulting in a near-complete response of disease inside the radiated area.To conclude, it was demonstrated that RT is an effective treatment modality to obtain symptom palliation and can be safely administered with an immunomodulatory drug.

Keywords: Extramedullary myeloma, bulky abdominal masses, radiotherapy, immunomodulatory drugs, pomalidomide

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