抄録
A 53-year-old female had been noticed proteinuria and hyper-tension since 1977 and developed renal failure and was treated with hemodialysis since October 19, 1978.
She was admitted to the Tokai University Hospital because of right exophthalmos on November 5, 1979. On admission physical examinations revealed right exophtahlmus, a huge conglomerated tumor sized 21.5×10.5cm. in pelvic cavity. Laboratory examinations demonstrated Hb 5.2Gm./100ml., ESR 160mm/hour, BUN 110mgm./100ml, total protein 8.4Gm./100ml., IgG 404mgm., IgA 24mgm., IgM 18mgm. and IgD 1,900mgm/100ml., positive λ type Bence Jones protein, 15.6% plasma cells in a sternal marrow aspirate, and punched out lesions in the skull X-ray film. Amyloidosis was excluded by intestinal biopsy.
Serum electrophoresis and agar immunoelectrophoresis demonstrated M protein identified as IgD (λ). Solid tumors in the right orbit, right lung and plevic cavity were detected by computer tomography scanning and tomography.
It was interesting that the tumor in the pelvic cavity was the largest in its size so far reported in the patients with IgD multiple myeloma at least in Japan. The tumor in the pelvic cavity was histopathologically confirmed as the extramedullary plasmacytoma. A combined chemotherapy using prednisolone, melphalan, cyclophosphamide and vincristine was begun and it was so effective that the plevic tumor could not be palpable in June 1980.
No report so far has been made in Japan on an orbital tumor in patients with IgD myeloma.
