title: Extraskeletal multiple myeloma presenting with an atrial mass: a case report and a review of the literature.
abstract: BACKGROUND
  Extraskeletal presentation at diagnosis or during the course of multiple myeloma is a rare event. The prognosis is usually very poor. At the moment there is no agreed gold standard for the treatment of this presentation.
  
  
  METHODS
  A 79-year-old Caucasian woman was treated at our hospital for right atrial myeloma localization. Our patient showed the following signs and symptoms of congestive heart failure: dyspnea, hypotension, cyanosis and facial edema. Surgery was not considered feasible due to the extent of the disease. Our patient underwent external-beam radiation therapy using an intensity modulated technique, thus obtaining a persistent complete remission. Our patient has been in continuous complete local remission for 25 months since the end of radiotherapy.
  
  
  CONCLUSIONS
  The role of radiotherapy is not defined in multiple myeloma with extraskeletal presentation. Our regimen seems to be effective in controlling the disease in this patient.This case report adds to the existing literature as it describes an unusual presentation of the disease and a new therapeutic approach to this rare presentation of multiple myeloma.
authors.affiliation: Department of Advanced Technologies, Radiation Oncology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy. federica.vigo@tiscali.it.
authors.forename: Federica
authors.initials: F
authors.lastname: Vigo
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ciammella
authors.forename: Riccardo
authors.initials: R
authors.lastname: Valli
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Cagni
authors.forename: Cinzia
authors.initials: C
authors.lastname: Iotti