ABSTRACT
Herein, we report a case of multiple myeloma with multiple plasmacytomas of thyroid, lung, lymph nodes and adrenal gland, who presented as upper airway and esophageal obstruction with vocal cord palsy. An 80-year-old women complained of dysphagia, hoarseness and anterior neck mass. Ultrasonography of the neck showed huge inhomogeneous solid mass involving left thyroid lobe and isthmus with several lymphadenopathy along the both upper deep cervical chain. Chest CT scanning revealed 4x3 cm sized, low density mass in posterobasal segment of the right lower lobe with both lower paratracheal lymphadenopathy, and abdominal CT scanning revealed 4.5x4.5 cm sized round low density mass in left adrenal gland. Serum and urine electrophoresis was normal and immunofixation of serum and urine was negative. Bone marrow smear and a bone scintigram revealed no abnormality, but iliac bone marrow biopsy revealed infiltration of abnormal plasma cells. Histologic and immunohistochemical examinations of the thyroid and lung mass revealed monoclonal proliferation of plasma cells of kappa light chain. After local irradiation of the neck with parenteral dexamethasone injection, anterior neck mass was much diminished in size, but 2 weeks later she had a pneumonia with fatal outcome.