title: Bortezomib combined with lenalidomide as the first-line treatment for the rare synchronous occurrence of multiple myeloma and pulmonary adenocarcinoma: A case report.
abstract: BACKGROUND
  Simultaneous multiple myeloma (MM) and pulmonary adenocarcinoma is a rare occurrence, and thus, treatment is a challenge. This study reports on 1 such case of MM with concurrent lung cancer, where an accurate diagnosis was made and the patient underwent treatment for both cancers.
  
  
  METHODS
  A 68-year-old man presented with 2 months of progressive lower back pain. Visualization with magnetic resonance imaging (MRI) revealed multiple collapsed vertebrae from T12 to S3, as well as an altered signal intensity at the T3 vertebra. The patient was diagnosed with MM upon examination. A chest computed tomography (CT) scan revealed a round mass in the left lower lobe of the lungs, and a CT-guided needle biopsy uncovered a moderately differentiated adenocarcinoma. There were no additional notable findings in the left lung using positron emission tomography computed tomography (PET-CT). Therefore, a diagnosis of MM with pulmonary adenocarcinoma was made. Surgery was performed to excise the lung cancer. Bortezomib was used as first-line induction therapy against both tumors and lenalidomide was used for maintenance. The patient went into complete remission. Using this combined chemotherapy, the patient has survived for over 3 years since a diagnosis was made despite relapsing twice after the first year.
  
  
  CONCLUSIONS
  This report clearly delineates the diagnosis and treatment of a rare case of synchronous MM and pulmonary adenocarcinoma, as well as depicts a potentially positive outcome for the patient. It also overviews some diagnostic and therapeutic implications for clinicians.
authors.affiliation: Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Wenli
authors.initials: W
authors.lastname: Zuo
authors.forename: Xinghu
authors.initials: X
authors.lastname: Zhu
authors.forename: Jingke
authors.initials: J
authors.lastname: Yang
authors.forename: Zhenyang
authors.initials: Z
authors.lastname: Mei
authors.forename: Mei
authors.initials: M
authors.lastname: Deng
authors.forename: Quande
authors.initials: Q
authors.lastname: Lin
authors.forename: Yongping
authors.initials: Y
authors.lastname: Song
authors.forename: Qingsong
authors.initials: Q
authors.lastname: Yin
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001707:Biopsy, Needle / Q000379:methods; D000069286:Bortezomib / Q000008:administration & dosage*; D006801:Humans; D000077269:Lenalidomide; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy / Q000473:pathology; D009378:Neoplasms, Multiple Primary; D000072078:Positron Emission Tomography Computed Tomography; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide