Abstract: FR-PO1284
Clinicopathologic Analysis of Untreated Multiple Myeloma in Rural South Georgia: A Cadaveric Case Study of Multisystem End-Organ Injury with Myeloma Cast Nephropathy
Session Information
- Onconephrology: Diagnostic Dilemmas, Therapy-Related Toxicities, and Clinical Cases
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Russell, Kenyot’a C., Philadelphia College of Osteopathic Medicine, Moultrie, Georgia, United States
- Araya, Saron, Philadelphia College of Osteopathic Medicine, Moultrie, Georgia, United States
Group or Team Name
- Myeloma Made Me Do It
Introduction
Multiple myeloma (MM) is a malignant plasma cell disorder characterized by osteolytic bone destruction, marrow infiltration, renal dysfunction, and systemic organ involvement. While advances in therapy have improved survival, untreated MM remains devastating, particularly in underserved populations with barriers to healthcare access. Postmortem studies of untreated MM are rare and provide valuable insight into the natural progression of disease. This cadaveric case study examines the gross and histopathologic manifestations of advanced untreated MM in a 73-year-old African American female from rural South Georgia.
Case Description
Gross anatomical examination demonstrated extensive multisystem disease involvement, including destructive osteolytic lesions of the vertebral column and multiple intraosseous and extraosseous plasmacytomas involving the chest wall and rib cage. Histopathologic analysis revealed extensive plasma cell infiltration within the L5 vertebral marrow with approximately 60–70% marrow involvement, osteolytic bone destruction, and extramedullary plasmacytoma formation. Renal tissue demonstrated classic light chain cast nephropathy with eosinophilic tubular casts, tubular epithelial injury, and interstitial damage consistent with “myeloma kidney.” These findings illustrate advanced end-stage MM in the absence of therapeutic intervention.
Discussion
This case provides a rare opportunity to examine the natural history of untreated MM and its severe end-organ consequences. The extensive skeletal destruction, extramedullary disease, and renal failure observed reflect aggressive disease progression beyond marrow confinement. Additionally, this case highlights the potential influence of healthcare disparities in underserved rural populations, where delayed diagnosis and limited access to specialty care may contribute to advanced disease presentation. The findings reinforce the importance of early diagnosis, timely intervention, and equitable access to hematologic care.
Acknowledgment
We would like to acknowledge the Philadelphia College of Osteopathic Medicine South Georgia Willed Body Program and the donor whose contribution made this research possible. We also thank Dr. Rasheed Agboola for his mentorship and support throughout this project, as well as the Department of Biomedical Sciences and Colquitt Regional Medical Center pathology laboratory for assistance with tissue processing and histopathologic analysis.