Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis<br />
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Sara Harrar; Abderrahim Raissi; Ayoub Bouchehboun; Ibtissam Mhirig; Saliha Chellak; Abderrahman Boukhira

doi:doi:10.11648/j.ijbse.20231104.11

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Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis

Sara Harrar^*, Abderrahim Raissi, Ayoub Bouchehboun, Ibtissam Mhirig, Saliha Chellak, Abderrahman Boukhira

Published in International Journal of Biomedical Science and Engineering (Volume 11, Issue 4)

Received: 1 June 2023 Accepted: 28 June 2023 Published: 28 October 2023

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Abstract

Breast carcinoma is a tumor that tends to metastasize to various organs. The hasty diagnosis of metastasis in patients treated for breast carcinoma who report symptoms for another malignant tumor, may be the cause of diagnostic and therapeutic delay. We report the case of a patient with breast ductal carcinoma, having completed her therapeutic protocol, she came in 3 years later with severe bone pain, epistaxis and headache in a context of asthenia and anorexia, suggesting a relapse of her breast cancer with bone metastasis. On clinical examination, the patient presented with cutaneous and mucosal pallor. She had no other signs of secondary localization, the performance of electrophoresis and immunofixation of serum proteins, led to a diagnosis of multiple myeloma. This observation highlights the diagnostic difficulty that can arise in patients treated for breast carcinoma who present with a malignant hemopathy mimicking a metastasis of the initial cancer, or other cases where the multiple myeloma is synchronous with other malignancies. This clinical similarity may delay treatment and worsen the patient's condition. This situation can be avoided by the simple performance of protein electrophoresis, which is a relevant method of diagnosis and follow-up of monoclonal gammopathies thanks to the efficient separation of serum proteins and quantification of monoclonal peaks.

Published in	International Journal of Biomedical Science and Engineering (Volume 11, Issue 4)
DOI	10.11648/j.ijbse.20231104.11
Page(s)	50-53
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Multiple Myeloma, Breast Carcinoma, Serum Protein Electrophoresis, Immunofixation

References

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[10]	Vennepureddy A, Motilal Nehru V, Liu Y, Mohammad F, Atallah JP. Synchronous Diagnosis of Multiple Myeloma, Breast Cancer, and Monoclonal B-Cell Lymphocytosis on Initial Presentation. Case Rep Oncol Med [Internet]. 2016 [cited 2021 Nov 29]; 2016: 1–4. Available from: http://www.hindawi.com/journals/crionm/2016/7953745/
[11]	Khalbuss WE, Fischer G, Ahmad M, Villas B. Synchronous Presentation of Breast Carcinoma with Plasmacytoid Cytomorphology and Multiple Myeloma. Breast J [Internet]. 2006 Mar [cited 2021 Nov 29]; 12 (2): 165–7. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1075-122X.2006.00226.x
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[14]	Cao F, Zhang R, Xu L, Liu M, Yuan Y. Application of Capillary Electrophoresis in Monoclonal Gammopathies and the Cutoff Value of Monoclonal Protein in Differential Diagnosis of Multiple Myeloma and Other Monoclonal Gammopathies. Ann Clin Lab Sci. mai 2021; 51 (3): 400–7.
[15]	McCudden CR, Mathews SP, Hainsworth SA, Chapman JF, Hammett-Stabler CA, Willis MS, et al. Performance comparison of capillary and agarose gel electrophoresis for the identification and characterization of monoclonal immunoglobulins. Am J Clin Pathol. 2008 Mar; 129 (3): 451–8.
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APA Style

Harrar, S., Raissi, A., Bouchehboun, A., Mhirig, I., Chellak, S., et al. (2023). Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis . International Journal of Biomedical Science and Engineering, 11(4), 50-53. https://doi.org/10.11648/j.ijbse.20231104.11

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ACS Style

Harrar, S.; Raissi, A.; Bouchehboun, A.; Mhirig, I.; Chellak, S., et al. Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis . Int. J. Biomed. Sci. Eng. 2023, 11(4), 50-53. doi: 10.11648/j.ijbse.20231104.11

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AMA Style

Harrar S, Raissi A, Bouchehboun A, Mhirig I, Chellak S, et al. Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis . Int J Biomed Sci Eng. 2023;11(4):50-53. doi: 10.11648/j.ijbse.20231104.11

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@article{10.11648/j.ijbse.20231104.11,
  author = {Sara Harrar and Abderrahim Raissi and Ayoub Bouchehboun and Ibtissam Mhirig and Saliha Chellak and Abderrahman Boukhira},
  title = {Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis

	
},
  journal = {International Journal of Biomedical Science and Engineering},
  volume = {11},
  number = {4},
  pages = {50-53},
  doi = {10.11648/j.ijbse.20231104.11},
  url = {https://doi.org/10.11648/j.ijbse.20231104.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbse.20231104.11},
  abstract = {Breast carcinoma is a tumor that tends to metastasize to various organs. The hasty diagnosis of metastasis in patients treated for breast carcinoma who report symptoms for another malignant tumor, may be the cause of diagnostic and therapeutic delay. We report the case of a patient with breast ductal carcinoma, having completed her therapeutic protocol, she came in 3 years later with severe bone pain, epistaxis and headache in a context of asthenia and anorexia, suggesting a relapse of her breast cancer with bone metastasis. On clinical examination, the patient presented with cutaneous and mucosal pallor. She had no other signs of secondary localization, the performance of electrophoresis and immunofixation of serum proteins, led to a diagnosis of multiple myeloma. This observation highlights the diagnostic difficulty that can arise in patients treated for breast carcinoma who present with a malignant hemopathy mimicking a metastasis of the initial cancer, or other cases where the multiple myeloma is synchronous with other malignancies. This clinical similarity may delay treatment and worsen the patient's condition. This situation can be avoided by the simple performance of protein electrophoresis, which is a relevant method of diagnosis and follow-up of monoclonal gammopathies thanks to the efficient separation of serum proteins and quantification of monoclonal peaks.
},
 year = {2023}
}

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TY  - JOUR
T1  - Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis

	

AU  - Sara Harrar
AU  - Abderrahim Raissi
AU  - Ayoub Bouchehboun
AU  - Ibtissam Mhirig
AU  - Saliha Chellak
AU  - Abderrahman Boukhira
Y1  - 2023/10/28
PY  - 2023
N1  - https://doi.org/10.11648/j.ijbse.20231104.11
DO  - 10.11648/j.ijbse.20231104.11
T2  - International Journal of Biomedical Science and Engineering
JF  - International Journal of Biomedical Science and Engineering
JO  - International Journal of Biomedical Science and Engineering
SP  - 50
EP  - 53
PB  - Science Publishing Group
SN  - 2376-7235
UR  - https://doi.org/10.11648/j.ijbse.20231104.11
AB  - Breast carcinoma is a tumor that tends to metastasize to various organs. The hasty diagnosis of metastasis in patients treated for breast carcinoma who report symptoms for another malignant tumor, may be the cause of diagnostic and therapeutic delay. We report the case of a patient with breast ductal carcinoma, having completed her therapeutic protocol, she came in 3 years later with severe bone pain, epistaxis and headache in a context of asthenia and anorexia, suggesting a relapse of her breast cancer with bone metastasis. On clinical examination, the patient presented with cutaneous and mucosal pallor. She had no other signs of secondary localization, the performance of electrophoresis and immunofixation of serum proteins, led to a diagnosis of multiple myeloma. This observation highlights the diagnostic difficulty that can arise in patients treated for breast carcinoma who present with a malignant hemopathy mimicking a metastasis of the initial cancer, or other cases where the multiple myeloma is synchronous with other malignancies. This clinical similarity may delay treatment and worsen the patient's condition. This situation can be avoided by the simple performance of protein electrophoresis, which is a relevant method of diagnosis and follow-up of monoclonal gammopathies thanks to the efficient separation of serum proteins and quantification of monoclonal peaks.

VL  - 11
IS  - 4
ER  -

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Author Information

Sara Harrar

Clinical Biochemistry and Toxicology Department, Avicenne Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco

Contact Email
Abderrahim Raissi

Clinical Hematology Department, Avicenne Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
Ayoub Bouchehboun

Clinical Biochemistry and Toxicology Department, Avicenne Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
Ibtissam Mhirig

Clinical Biochemistry and Toxicology Department, Avicenne Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
Saliha Chellak

Clinical Biochemistry and Toxicology Department, Avicenne Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
Abderrahman Boukhira

Clinical Biochemistry and Toxicology Department, Avicenne Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco

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Plain Text BibTeX RIS

APA Style

Harrar, S., Raissi, A., Bouchehboun, A., Mhirig, I., Chellak, S., et al. (2023). Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis . International Journal of Biomedical Science and Engineering, 11(4), 50-53. https://doi.org/10.11648/j.ijbse.20231104.11

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ACS Style

Harrar, S.; Raissi, A.; Bouchehboun, A.; Mhirig, I.; Chellak, S., et al. Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis . Int. J. Biomed. Sci. Eng. 2023, 11(4), 50-53. doi: 10.11648/j.ijbse.20231104.11

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AMA Style

Harrar S, Raissi A, Bouchehboun A, Mhirig I, Chellak S, et al. Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis . Int J Biomed Sci Eng. 2023;11(4):50-53. doi: 10.11648/j.ijbse.20231104.11

Copy | Download

@article{10.11648/j.ijbse.20231104.11,
  author = {Sara Harrar and Abderrahim Raissi and Ayoub Bouchehboun and Ibtissam Mhirig and Saliha Chellak and Abderrahman Boukhira},
  title = {Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis

	
},
  journal = {International Journal of Biomedical Science and Engineering},
  volume = {11},
  number = {4},
  pages = {50-53},
  doi = {10.11648/j.ijbse.20231104.11},
  url = {https://doi.org/10.11648/j.ijbse.20231104.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbse.20231104.11},
  abstract = {Breast carcinoma is a tumor that tends to metastasize to various organs. The hasty diagnosis of metastasis in patients treated for breast carcinoma who report symptoms for another malignant tumor, may be the cause of diagnostic and therapeutic delay. We report the case of a patient with breast ductal carcinoma, having completed her therapeutic protocol, she came in 3 years later with severe bone pain, epistaxis and headache in a context of asthenia and anorexia, suggesting a relapse of her breast cancer with bone metastasis. On clinical examination, the patient presented with cutaneous and mucosal pallor. She had no other signs of secondary localization, the performance of electrophoresis and immunofixation of serum proteins, led to a diagnosis of multiple myeloma. This observation highlights the diagnostic difficulty that can arise in patients treated for breast carcinoma who present with a malignant hemopathy mimicking a metastasis of the initial cancer, or other cases where the multiple myeloma is synchronous with other malignancies. This clinical similarity may delay treatment and worsen the patient's condition. This situation can be avoided by the simple performance of protein electrophoresis, which is a relevant method of diagnosis and follow-up of monoclonal gammopathies thanks to the efficient separation of serum proteins and quantification of monoclonal peaks.
},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis

	

AU  - Sara Harrar
AU  - Abderrahim Raissi
AU  - Ayoub Bouchehboun
AU  - Ibtissam Mhirig
AU  - Saliha Chellak
AU  - Abderrahman Boukhira
Y1  - 2023/10/28
PY  - 2023
N1  - https://doi.org/10.11648/j.ijbse.20231104.11
DO  - 10.11648/j.ijbse.20231104.11
T2  - International Journal of Biomedical Science and Engineering
JF  - International Journal of Biomedical Science and Engineering
JO  - International Journal of Biomedical Science and Engineering
SP  - 50
EP  - 53
PB  - Science Publishing Group
SN  - 2376-7235
UR  - https://doi.org/10.11648/j.ijbse.20231104.11
AB  - Breast carcinoma is a tumor that tends to metastasize to various organs. The hasty diagnosis of metastasis in patients treated for breast carcinoma who report symptoms for another malignant tumor, may be the cause of diagnostic and therapeutic delay. We report the case of a patient with breast ductal carcinoma, having completed her therapeutic protocol, she came in 3 years later with severe bone pain, epistaxis and headache in a context of asthenia and anorexia, suggesting a relapse of her breast cancer with bone metastasis. On clinical examination, the patient presented with cutaneous and mucosal pallor. She had no other signs of secondary localization, the performance of electrophoresis and immunofixation of serum proteins, led to a diagnosis of multiple myeloma. This observation highlights the diagnostic difficulty that can arise in patients treated for breast carcinoma who present with a malignant hemopathy mimicking a metastasis of the initial cancer, or other cases where the multiple myeloma is synchronous with other malignancies. This clinical similarity may delay treatment and worsen the patient's condition. This situation can be avoided by the simple performance of protein electrophoresis, which is a relevant method of diagnosis and follow-up of monoclonal gammopathies thanks to the efficient separation of serum proteins and quantification of monoclonal peaks.

VL  - 11
IS  - 4
ER  -

Copy | Download