American Journal of Cancer Prevention
ISSN (Print): 2328-7314 ISSN (Online): 2328-7322 Website: http://www.sciepub.com/journal/ajcp Editor-in-chief: Nabil Abdel-Hamid
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American Journal of Cancer Prevention. 2016, 4(2), 33-35
DOI: 10.12691/ajcp-4-2-3
Open AccessCase Report

A Case of Second Primary Multiple Myeloma Mimicking Bone Metastases in a Patient with Breast Cancer: An Approach to Osseous Metastases

Nurhan Onal Kalkan1, Muhammed Aslanboga1 and Erkan Dogan1,

1Department of Medical Oncology, Yuzuncu Yil University Medical Faculty, Van, Turkey

Pub. Date: July 19, 2016

Cite this paper:
Nurhan Onal Kalkan, Muhammed Aslanboga and Erkan Dogan. A Case of Second Primary Multiple Myeloma Mimicking Bone Metastases in a Patient with Breast Cancer: An Approach to Osseous Metastases. American Journal of Cancer Prevention. 2016; 4(2):33-35. doi: 10.12691/ajcp-4-2-3

Abstract

A 62-year-old female patient received adjuvant chemotherapy after a mastectomy due to a locally advanced invasive ductal carcinoma eight years ago. During the follow-up, she complained of extensive backache, so a plain radiography was taken. The radiography showed diffuse lytic lesions located primarily around the vertebrae and sternum. Given that the bone lesions could be related to osseous metastases of the breast cancer, a bone scintigraphy was performed and no positive involvement was observed. Magnetic resonance imaging was subsequently applied and diffuse hypointense areas were found on the vertebrae. The patient had also accompanying bicytopenia (thrombocytopenia and luecocytopenia), albumin/globulin inversion and hyperglobulinemia. As the patient did not have such involvement in regard to her overall body scintigraphy and there were accompanying abnormal biochemical parameters, it was concluded that the patient’s bone lesions were an outcome of a hematological malignity. Bone marrow aspiration and the biopsy result were found to be consistent with multiple myeloma (MM). It was thus confirmed that the lytic lesions were not related to breast cancer but rather MM bone lesions. We are able to conclude, based on the case presented herein, that newly-developing bone lesions on patients with breast cancer must be approached with suspicion, and their other laboratory analyses and imaging diagnostic processes must be evaluated carefully. It is necessary to keep in mind that such a condition might be related to other diseases, however rare the occurrence.

Keywords:
second primary cancer breast cancer multiple myeloma bone metastasis bone scintigraphy

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References:

[1]  Jemal A, Siegel R, Ward E et al. Cancer statistics, 2006. CA Cancer J Clin 2006;56:106-130.
 
[2]  Sinn HP, Kreipe H. A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition. Breast Care (Basel) 2013;8:149-154.
 
[3]  Puglisi F, Follador A, Minisini AM et al. Baseline staging tests after a new diagnosis of breast cancer: further evidence of their limited indications. Ann Oncol 2005;16:236-6.
 
[4]  Yochum TR, Rowe LJ. Tumors and Tumorlike Processes; Essentials of Skeletal Radiology. Baltimore: Williams & Wilkins, 1996: 1004-13.
 
[5]  Carnesale PG. Malignant Bone Tumors; Campbell’s Operative Orthopaedics. St.Louis: Mosby-Year Book Inc, 1998: 726-727.
 
[6]  Clayer M, Duncan W. Importance of biopsy of new bone lesions in patients with previous carcinoma. Clin Orthop Relat Res. 2006;451:208-11.
 
[7]  Roodman GD. Mechanisms of bone metastasis. N Engl J Med. 2004;350:1655-64. Review.
 
[8]  R. Gunderman, Essential Radiology, Thieme Medical Publishers, New York, NY, USA, 2nd edition, 2006
 
[9]  Hopkins GB, Kristensen KA. Whole body skeletal scintiphotography in the detection of occult metastatic breast carcinomas. Calif Med. 1973;119:10-3.
 
[10]  Galasko CS. Skeletal metastases and mammary cancer. Ann R Coll Surg Engl. 1972;50:3-28.
 
[11]  Dillman CE Jr, Silverstein MN. Alkaline phosphatase in multiple myeloma. Am J Med Sci. 1965;249:445-7.
 
[12]  Fried JR, Goldberg H, Herrman JB. Treatment of metastases from cancer of the breast. Am JRoentgenol 1950; 63:312-33.
 
[13]  Yochum TR, Rowe LJ. Tumors and Tumorlike Processes; Essentials of Skeletal Radiology. Baltimore: Williams & Wilkins, 1996: 1004-13.
 
[14]  Brown SB, Mallon EA, Edwards J et al.TG. Is the biology of breast cancer changing? A study of hormone receptor status 1984-1986 and 1996-1997. Br J Cancer. 2009;100:807-10.