Mark,
Ask for a referral to a neurosurgeon or an orthopedic surgeon who has completed a fellowship in spine surgery; a person can have myeloma cell tumour (neoplasm) in their spine without having full-blown multiple myeloma or M-spike results; it's called solitary bone plasmacytoma, usually by way of a lytic lesion.
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: Could it be multiple myeloma?
LM,
I may not have correctly understood what you meant to say, but just to make sure... You can be diagnosed with a solitary bone plasmacytoma and also have an M-spike (or abnormal free light chain ratio). Or, to put it another way, having an M-spike or abnormal FLC ratio does not mean that you have multiple myeloma rather than a solitary bone plasmacytoma.
I believe that something like a third to three quarters of patients diagnosed with solitary bone plasmacytoma have an M-spike. It's not uncommon.
It also makes sense. Plasmacytomas, wherever they are – in the bone, in the marrow, or out in the soft tissue – are going to secrete monoclonal proteins in almost all cases. The only exception will be if the plasmacytoma is truly non-secretory, which is rare (maybe a few percentage points of myeloma cases). Probably the only reason you don't see an M-spike, or abnormal FLC ratio, in some solitary bone plasmacytoma cases is because the plasmacytoma is so small that the M-spike isn't large enough to be detected.
I may not have correctly understood what you meant to say, but just to make sure... You can be diagnosed with a solitary bone plasmacytoma and also have an M-spike (or abnormal free light chain ratio). Or, to put it another way, having an M-spike or abnormal FLC ratio does not mean that you have multiple myeloma rather than a solitary bone plasmacytoma.
I believe that something like a third to three quarters of patients diagnosed with solitary bone plasmacytoma have an M-spike. It's not uncommon.
It also makes sense. Plasmacytomas, wherever they are – in the bone, in the marrow, or out in the soft tissue – are going to secrete monoclonal proteins in almost all cases. The only exception will be if the plasmacytoma is truly non-secretory, which is rare (maybe a few percentage points of myeloma cases). Probably the only reason you don't see an M-spike, or abnormal FLC ratio, in some solitary bone plasmacytoma cases is because the plasmacytoma is so small that the M-spike isn't large enough to be detected.
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JimNY
Re: Could it be multiple myeloma?
I would just add one thing to what Jim said. Yes, you can certainly have an M-spike and be diagnosed as having solitary plasmacytoma. But this is provided that your bone marrow plasma cell percentage (BMPC) is less than 10%. Otherwise, the condition has a different diagnosis.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Could it be multiple myeloma?
I think Multibilly explained it better than I did. Yes, you can have an M-spike together with a solitary bone plasmacytoma (SBP), but within the 10 percent bone marrow plasma cell percentage realm.
I didn't mean to imply that no one with SBP will have an M-spike; what I meant to imply is that you can have SBP and have no M-spike show up on the 24-hour urine test (I forget the name for it).
I didn't mean to imply that no one with SBP will have an M-spike; what I meant to imply is that you can have SBP and have no M-spike show up on the 24-hour urine test (I forget the name for it).
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: Could it be multiple myeloma?
Thank you everyone.
Went to the myeloma doctor here in South Africa. He explained that the so-called lesions are hameongemias, which are benign blood clots kind of thing, and are found incidentally on a lot of people. Not much can be done about it.
But yet I still decided to pursue further and decided to do the bone marrow biopsy, bone aspiration, and full skeletal survey. Thank God all is clear and there are no lytic lesions or plasma cell damage.
Went to the myeloma doctor here in South Africa. He explained that the so-called lesions are hameongemias, which are benign blood clots kind of thing, and are found incidentally on a lot of people. Not much can be done about it.
But yet I still decided to pursue further and decided to do the bone marrow biopsy, bone aspiration, and full skeletal survey. Thank God all is clear and there are no lytic lesions or plasma cell damage.
Re: Could it be multiple myeloma?
Hi Mark,
I'm glad that you got some clarification from your doctor on what's going on. As was pointed out by other earlier, it didn't look like something myeloma-related was the source of the problems you were having, but it's good to have that confirmed. I also appreciate your coming back and letting us all know what you learned from your doctor's appointment.
LM and Multibilly - Thanks for the extra comments in addition to what I originally posted. My earlier posting was just to make sure no one misunderstood what LM initially posted, and came away thinking that solitary plasmacytomas, whether in the bone or elsewhere, never create an M-spike or elevated free light chains.
I'm glad that you got some clarification from your doctor on what's going on. As was pointed out by other earlier, it didn't look like something myeloma-related was the source of the problems you were having, but it's good to have that confirmed. I also appreciate your coming back and letting us all know what you learned from your doctor's appointment.
LM and Multibilly - Thanks for the extra comments in addition to what I originally posted. My earlier posting was just to make sure no one misunderstood what LM initially posted, and came away thinking that solitary plasmacytomas, whether in the bone or elsewhere, never create an M-spike or elevated free light chains.
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JimNY
Re: Could it be multiple myeloma?
So, Mark ... You are from SA, how'zit?
We have so many South African doctors around here, they are well respected here in Canada.
We have so many South African doctors around here, they are well respected here in Canada.
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
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