SCRANTON, PA — Dr. Maimona Chaudhary, an internal medicine resident at The Wright Center, first the 25-year-old woman while on rotation at Geisinger Community Medical Center.
The patient arrived at the emergency department with lesions on her legs. What medical personnel initially diagnosed as second-degree burns ended up being a rare symptom of biclonal multiple myeloma—a cancer that only affects people under the age of 40 in about two percent of cases.
“Upon follow-up, the lesions were diagnosed as paraneoplastic pemphigus, which is rare in itself,” said Dr. Chaudhary. “But then they found she had multiple myeloma, without any of the usual symptoms, without any family history. There were a lot of oddities in this case.”
This chance meeting with a patient led to the opportunity to present a winning scholarly abstract about a medical rarity at the American College of Physicians (ACP) Internal Medicine Meeting in Boston, MA.
Dr. Chaudhary, a first-year resident physician from Hamilton, Ontario, followed the patient’s case over the next several months and produced a case report with colleagues from The Wright Center, including Drs. Ali Shah and Lehka Yadukumar, internal medicine residency physicians; Dr. Milos Babic, associate director of the program; and medical student Omaima Chaudhary, who received her medical degree from the University of Limerick School of Medicine and will join The Wright Center for Graduate Medical Education’s Internal Medicine Residency in July.
The researchers submitted the case report, “Paraneoplastic Pemphigus as the Presenting Sign of Biclonal Multiple Myeloma in a 25-Year Old Female: A Case Report,” to the ACP’s resident/fellow national abstract competition, which receives several hundred entries annually. The abstract was one of 20 awarded a certificate of merit by the ACP. Dr. Chaudhary delivered the five-minute presentation on the case.
“It was difficult to cover everything in five minutes,” she said. “I think this case really stood out to the ACP judges because it was so unusual.”
Dr. Chaudhary monitored the patient’s case, although she is not involved in her ongoing treatment. The woman’s cancer treatment was delayed for months as doctors worked to heal the skin lesions caused by paraneoplastic pemphigus, along with other complications. She recently began chemotherapy, and all signs point to a positive outcome.
As for Dr. Chaudhary’s future, she’s still deciding what type of medicine to pursue.
“I’m still exploring,” she said. “I want to do something I really enjoy. We get to pick electives in our second year, so I can start to see where I want to go from here.”
The Wright Center for Graduate Medical Education was established in 1976 as the Scranton-Temple Residency Program, a community-based internal medicine residency. Today, The Wright Center is one of the largest U.S. Health Resources and Services Administration-funded Teaching Health Center Graduate Medical Education Safety-Net Consortiums in the nation.
The Wright Center for Graduate Medical Education’s residency and fellowship programs are accredited by the Accreditation Council for Graduate Medical Education. For more information, go to TheWrightCenter.org or call 570/866-3017.