Solitary Chest Wall Tumor Is the Initial Clinical Manifestation of Multiple Myeloma: Report A Case and Review Literature

多發性骨髓瘤以單一胸廓腫瘤表現：病例報告及文獻探討

林鴻生(Hong-Shen Lin) ； 管毅剛(Yih-Gang Goan) ； 張晃宙(Huang-Chou Chang)

《南臺灣醫學雜誌》 2卷1期 (2006/12) Pp. 16-20

https://doi.org/10.6726/MJST.200612_2(1).0004

摘要

病患為五十七歲之男性，其右前胸有一處半年來逐漸變大的腫塊，且引發疼痛而前來求診。經胸部X光及胸部電腦斷層攝影，發現只有一處單一蝕骨性病灶位於右側第五肋骨。核子醫學骨骼掃瞄亦只顯示在右側第五肋骨有熱點反應。初步懷疑為惡性腫瘤轉移至肋骨所造成之病灶。為求進一步之確定診斷，乃以手術切除胸廓腫瘤。組織病理檢驗結果發現為漿細胞瘤。經免疫組織化學染色法則顯示kappa鏈陽性反應。而尿液中的Bence-Jones蛋白呈現陰性。另於追加的放射線檢查中，發現其四肢、顱骨及脊椎骨有多處囊袋狀病灶。最後確立診斷為多發性骨髓瘤。

關鍵字

胸廓腫瘤 ； 多發性骨髓瘤

並列摘要

A 57 year-old male patient suffered from a progressive enlarged tender mass lesion over right anterior chest wall for half year. Initial chest roentgenogram and computed tomography only demonstrated a solitary osteolytic lesion with bony expansion and destruction over right 5 rib. Whole body bone scan showed a segmental hot spot over anterior aspect of right 5th rib without associating with other suspected lesions. Malignant disease of unknown origin with rib metastasis was impressed initially. Therefore, en-block resection of chest wall was performed for tissue diagnosis. The result of histopathologic examination presented a picture of plasmacytoma. Immunohistochemistry disclosed positive stain of kappa chain. The urinary Bence-Jones protein was negative. As the supplementary roentgenography exhibited multiple pouch-out lesions over limbs, skull as well as spine, multiple myeloma was diagnosed finally.

並列關鍵字

chest wall tumor ； multiple myeloma