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NDT Advance Access originally published online on July 26, 2005
Nephrology Dialysis Transplantation 2005 20(12):2827-2829; doi:10.1093/ndt/gfi034
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Case Report

Fistula dysfunction secondary to a subcutaneous myelomatous deposit

David Boshell1, Rohan Sabharwal1, Ross Keen1, Patrick Coleman2, Philip Vladica1 and Simon D. Roger3

1 Department of Radiology, Westmead Hospital, Sydney, NSW, Australia, 2 Department of Medicine, Manly District Hospital, Sydney, NSW, Australia and 3 Department of Renal Medicine, Gosford Hospital, Gosford, NSW, Australia

Correspondence and offprint requests to: Dr David Boshell, 2 Dutruc Street, Randwick NSW 2031, Australia. Email: daveboy@tpg.com.au

Keywords: arteriovenous fistula (AV fistula); dialysis complications; fistula dysfunction; multiple myeloma; subcutaneous myeloma

The first 150 words of the full text of this article appear below.



   Introduction
 
Arteriovenous fistula dysfunction is a frequent complication in, and hindrance to, patients with end stage kidney disease undergoing renal replacement therapy with intermittent haemodialysis. We present an unusual complication in a 68-year-old male patient undergoing haemodialysis therapy for end stage kidney failure caused by biopsy-proven multiple myeloma. We explore the occurrence of an extramedullary cutaneous myeloma deposit situated adjacent to an arteriovenous fistula resulting in fistula dysfunction. This is the first reported case in the English literature of a myeloma deposit encasing an arteriovenous fistula, deriving its blood supply from the fistula and thus undergoing rapid growth, eventually leading to fistula dysfunction.



   Case
 
A 68-year-old man presented to his local doctor with a 6 week history of constitutional symptoms including lethargy, anorexia, nausea, slow healing rib injury and generalized progressive malaise. His past medical history was unremarkable except for a previously excised superficial malignant melanoma over his left scapula. Investigations on . . . [Full Text of this Article]



   Discussion
 


   Conclusion
 

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