Introduction

A 71-year-old woman with an ovarian cyst was referred to our hospital for bilateral leg oedema and dyspnoea on exertion. She had no significant medical history and no history of smoking or alcohol consumption. Physical examination showed bilateral oedema of the lower extremities. Laboratory tests revealed a haemoglobin level of 76 g/L (normal range: 111–151 g/L), calcium levels of 10.6 mg/dL (normal range: 8.0–10.0 mg/dL) and low immunoglobulin A, M and G levels. Kappa immunoglobulin light-chain proteins were detected in her urine. Bone marrow aspiration revealed abnormal monoclonal plasma cells. These findings led to a diagnosis of multiple myeloma. The patient received a combination of daratumumab, lenalidomide …