Clinical Analysis Of A Case Of Waldenstrom’s Macroglobulinemia With Undifferentiated Pleomorphic Sarcoma

[Objective]To explore the clinical features, diagnosis, treatment and prognosis of Waldenstrom’s Macroglobulinemia complicated with Undifferentiated Pleomorphic Sarcoma.[Methods]A Waldenstrom’s macroglobulinemia patient complicated with undifferentied pleomorphic sarcoma in our hospital in December 2013 was restropectively analyzed. A brief report:A 66-year-old female patient, was admitted for repeated fever for a month on December 17,2013. There was no obvious abnormality in physical examination. Laboratory examination revealed:decreased hemoglobin of 110g/l (normal range:115-150g/l), increased serum immunoglobulin M (IgM) of 21.6g/l (normal range:0.4-2.3g/l), positive protein immunofixation for IgM heavy chain and λ light chain in serum. Bone marrow aspiration found increased lymphocytoid plasmacytes.The diagnosis of Waldenstrom’s Macroglobulinemia was made and during the treatment of chlorambucil, a nontender mass was accidentally found in her left thigh with the size like an egg. She didn’t take notice, and the mass increased gradually. Magnetic Resonance Imaging on June 23,2014 revealed multiple soft-tissue nodules, the largest one being 6.9cm×4.8cm×5.4cm, and obvious heterogeneous density in enhanced scan. The signal of her left femur was normal. In order to characterize the masses, a biopsy was performed on July XX,2014 and the result was consistent with undifferentiated pleomorphic sarcoma, and the consultation of Beijing Cancer Hospital met the diagnosis. The patient couldn’t accept the suggestion of amputation, so she was transferred for radiotherapy at last. The patient lives up to now.[Conclusions]Waldenstrom’s macroglobulinemia has slow onset, atypical symptoms, many complications, so it is easy to miss or misdiagnose. As for the diagnosis, the test of immunoglobulin in serum and bone marrow aspiration are important choices. There is no specific medicine at present. Undifferentiated pleomorphic sarcoma, it is a type of malignant soft-tissue tumor, which lacks typical clinical manifestations and positive laboratory findings. Diagnosis relies on the biopsy and immunohistochemical analysis. The treatment requires adjuvant therapy after operation. There are rare reports of Waldenstrom’s macroglobulinemia complicated with undifferentiated pleomorphic sarcoma. We hope that this study would provide assist and experience in such patients.