Unusual Presentation of Multiple Myeloma as a Liver Tumor at Initial Diagnosis: A Case Report
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND Multiple myeloma (MM) is a hematologic cancer marked by malignant plasma cells in the bone marrow, often leading to bone pain, anemia, and renal issues. Rarely, MM presents as extramedullary myeloma in organs such as the liver, and is associated with a poor prognosis. CASE REPORT We report a 64-year-old woman with a history of aortic stenosis and transient ischemic attack who presented with severe anemia, epistaxis, and fatigue. Initial test results showed elevated liver enzymes, hypercalcemia, and kidney injury, with imaging revealing suspected liver metastases. Cancer markers, such as carcinoembryonic antigen, cancer antigen 15-3, and cancer antigen 125 were elevated. Liver biopsy showed plasma cells positive for CD138, CD38, and CD56, confirming MM. Additional tests found IgA kappa monoclonal proteins and 60% plasma cells in bone marrow, without bone lesions. The patient required an extended hospital stay, due to recurrent pleural effusions, hypercalcemia, and cholangitis requiring stent placement. After recovery from complications, including COVID-19, she was treated with 7 cycles of daratumumab-dexamethasone-lenalidomide and was scheduled for an autologous stem cell transplant. After 4 months of treatment, the patient had positive clinical outcomes in myeloma parameters and liver lesions. The patient had improved hemoglobin, white blood cells, neutrophils, and platelets. The patient's IgA decreased, hepatic enzymes improved, monoclonal protein bands disappeared, and liver lesions resolved. CONCLUSIONS This case highlights an uncommon MM presentation with liver involvement, underscoring the importance of considering MM in the differential diagnosis of atypical liver lesions and of early identification to improve treatment outcomes.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it