Retroperitoneal fibrosis: A rare manifestation of extramedullary dissemination of multiple myeloma

Fibi Ninan, Ajay Kumar Mishra, Ajoy Oommen John, Iyadurai Ramya Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India

Figure 1: Coronal section of abdomen showing features of retroperitoneal


Multiple myeloma is a neoplasm that occurs due to monoclonal proliferation of plasma cells. Anemia, hypercalcemia, renal failure, and osteolytic lesions are the common manifestations. Less than 5% of patients present with extramedullary dissemination at the time of diagnosis. The common sites of extramedullary dissemination are liver, spleen, adrenals, and lung. Spread of myeloma into retroperitoneum causing retroperitoneal fibrosis is one of the rare manifestations. Patients with disseminated myeloma are usually young and have a poor disease-free survival rate. Aggressive therapy in the form of stem cell transplant has shown to be of benefit in such patients.

Keywords: Extramedullary dissemination of myeloma, multiple myeloma, retroperitoneal fibrosis


Multiple myeloma is a hematological malignancy which occurs secondary to uncontrolled monoclonal proliferation of plasma cells.[1] The disease usually remains confined to the skeleton and bone marrow, and the clinical manifestations are secondary to tissue or organ impairment, namely, hypercalcemia, anemia, renal failure, and bon