Extramedullary lesions to the pericardium and right atrium in refractory multiple myeloma

A 79-year-old woman visited our hospital because of back pain. Laboratory examination showed monoclonal l light chains in the serum, and a population of 60% CD138 1 plasma cells was found on bone marrow biopsy. Karyotype was normal, and whole-body computed tomography (CT) found no extramedullary lesions. She was diagnosed with immunoglobulin A l-type multiple myeloma (MM), classified as stage 2 according to the Revised International Staging System; she started treatment with bortezomib plus dexamethasone and achieved complete response. One year later, multiple tumors in her right mammary gland were detected on CT. Mammary gland biopsy found plasmacytoma, resulting in a diagnosis of extramedullary lesions in MM. Four years after first visit, she was admitted with heart failure.