#00060394

83-year-old male diagnosed in 2011 with multiple myeloma stage III, IgG kappa. Patient presented with lytic lesions and renal failure. Cytogenetics was positive for IgH-FGFR3 translocation and Del 13. He was originally treated with bortezomib and dexamethasone. Subsequently underwent treatment with melphalan, prednisone and bortezomib. Three years later the patient progressed with a plasmacytoma on the 7th rib. Patient was treated with radiation therapy followed by lenalidomide and dexamethasone. After 3 cycles, treatment was stopped due to side effects. He remained in remission until June 2014 when he presented with lower and upper extremity nodular lesions (Figures A & B). Patient received bortezomib and dexamethasone in combination with irradiation for the plasmacytomas which achieved a near complete resolution of the cutaneous lesion as shown in figures C & D.