收稿日期: 2024-05-15
录用日期: 2024-09-27
网络出版日期: 2025-01-28
A case report of relapsed and refractory multiple myeloma with multifocal extramedullary infiltration and pulmonary adenocarcinoma
Received date: 2024-05-15
Accepted date: 2024-09-27
Online published: 2025-01-28
当前多发性骨髓瘤仍然不可治愈，多数患者经历多线复发，最终难治。髓外浸润是复发的一种常见形式，同时期的多病灶髓外浸润与继发的第二肿瘤难以鉴别。该文报告了1例复发难治性多发性骨髓瘤多处髓外浸润的患者，经多学科会诊，明确其为骨髓瘤髓外浸润与肺腺癌共存的病例。多病灶髓外浸润与肺腺癌的共存在临床上较为罕见，给患者的诊治决策带来了重大挑战。该文通过病例报道和文献复习，探讨骨髓瘤多病灶髓外浸润与共存的继发肿瘤的诊治，强调多学科会诊在实现精确诊断和优化患者预后方面的关键作用。
关键词： 复发难治性多发性骨髓瘤; 髓外浸润; 肺腺癌; 同期共存; 诊疗
杜芳 , 周凌云 , 陈姣 , 刘丹波 , 向泓先 , 陈海飞 . 复发难治性多发性骨髓瘤伴多病灶髓外浸润合并肺腺癌1例报道[J]. 上海交通大学学报（医学版）, 2025 , 45(1) : 122 -128 . DOI: 10.3969/j.issn.1674-8115.2025.01.015
Multiple myeloma (MM) remains an incurable disease, with most patients experiencing multiple relapses before ultimately progressing to refractory stage. Extramedullary infiltration is a common manifestation of relapse. However, distinguishing synchronous multifocal extramedullary infiltration from secondary malignancies poses significant diagnostic challenges. This study presents a case of relapsed refractory MM with multifocal extramedullary infiltration, diagnosed as coexistence of multiple myeloma extramedullary infiltration and pulmonary adenocarcinoma through multidisciplinary team (MDT) collaboration. Such coexistence is exceedingly rare in clinical practice and introduces substantial complexity in diagnosis and treatment planning. Through a comprehensive case report and literature review, this paper explores the diagnostic and therapeutic approaches to managing multifocal extramedullary infiltration coexisting with secondary malignancies in MM, highlighting the pivotal role of MDT in achieving precise diagnosis and optimizing patient outcomes.
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