title: Immunoglobulin D myeloma presenting as an extraosseous soft tissue tumor.
abstract: We report a 69-year-old man who suffered an extraosseous tumor of immunoglobulin D myeloma (lambda type) in the shoulder girdle, mimicking a primary soft tissue sarcoma. The tumor was isointense with adjacent muscle on T1-weighted MR images, and hyperintense on T2-weighted images. No continuity with the neighboring bone was noted. After administration of gadolinium, the central part of the tumor showed marked contrast enhancement. Although the tumor showed a complete response to the initial chemotherapy, the patient died of the disease 31 months after its initial manifestation. Several bone marrow aspirations and biopsies of the ilium and sternum had shown no increase in plasma cells (range 0.6-1.2%) until the disease became advanced 19 months after its initial manifestation.
authors.affiliation: Department of Orthopaedic Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Mochizuki
authors.forename: K
authors.initials: K
authors.lastname: Katayama
authors.forename: F
authors.initials: F
authors.lastname: Kikuchi
authors.forename: I
authors.initials: I
authors.lastname: Saito
authors.forename: M
authors.initials: M
authors.lastname: Homori
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003606:Dacarbazine / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D007069:Ifosfamide / Q000627:therapeutic use; D007072:Immunoglobulin D; D007146:Immunoglobulin lambda-Chains; D008279:Magnetic Resonance Imaging; D008297:Male; D015080:Mesna / Q000627:therapeutic use; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D012782:Shoulder / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology
chemical_list: D007072:Immunoglobulin D; D007146:Immunoglobulin lambda-Chains; D003606:Dacarbazine; D004317:Doxorubicin; D015080:Mesna; D007069:Ifosfamide