Case Report Unusual Case of Simultaneous Presentation of Plasma Cell Myeloma, Chronic Myelogenous Leukemia, and a Jak2 Positive Myeloproliferative Disorder J. Maerki, 1 G. Katava, 1 D. Siegel, 2 J. Silberberg, 3 and P. K. Bhattacharyya 2 1 Rutgers-NJMS, Te State University of New Jersey, Newark, NJ 07103, USA 2 Hackensack University Medical Center, Hackensack, NJ 07601, USA 3 Regional Cancer Care Associates, Freehold, NJ 07728, USA Correspondence should be addressed to J. Maerki; maerkijk@rutgers.edu Received 17 July 2014; Accepted 29 September 2014; Published 15 October 2014 Academic Editor: Marie-Christine Kyrtsonis Copyright © 2014 J. Maerki et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Multiple articles discuss the rare incidence and potential causes of second hematologic disorders arising afer treatment of Chronic Myelogenous Leukemia (CML), leading to the theory of imatinib, the current treatment regimen for CML, as a possible trigger for the development of secondary neoplasms. Our case eliminates the possibility of imatinib as the sole cause since our patient received a diagnosis of simultaneous plasma cell myeloma, CML, and a Jak2 mutation positive myeloproliferative disorder (MPD) arising de novo, prior to any treatment. We will further investigate into alternative theories as potential causes for multiple hematopathologic disorders. Case Report. Tere are currently no reported cases with the diagnosis of simultaneous plasma cell myeloma, chronic myelogenous leukemia, and Jak2 positive myeloproliferative disorder. We present a case of a 77-year-old male who was discovered to have these three concurring hematopathologic diagnoses. Our review of the literature includes a look at potential associations linking the three coexisting hematologic entities. Conclusion. Te mechanism resulting in simultaneous malignancies is most likely multifactorial and potentially includes factors specifc to the host, continuous stimulation of the immune system, previous chemotherapy or radiation, a potential common pluripotent stem cell, or, lastly, preexisting myeloma which may increase the susceptibility of additional malignancies. 1. Introduction Plasma cell myeloma, a hematologic neoplasm of lymphoid origin, has an incidence of 4.5 cases per 100,000 person annually in the United States while Chronic Myelogenous Leukemia, a neoplasm of myeloid origin, has an incidence of 1-2 cases per 100,000 person annually worldwide. As coexisting hematologic neoplasms in general are a rare entity, there are only a limited number of case reports with both multiple myeloma and CML [1–13]. Literature review shows case reports of new hematopathologic neoplasms occurring afer treatment of an initial hematologic malignancy; this can be a single additional neoplasm or up to three new neoplasms afer treatment. Examples of such cases include multiple myeloma afer treatment for CML with imatinib [9, 10, 14, 15] and a unique case of three coexisting lymphomas including primary cutaneous marginal zone B cell lymphoma (MZBL), nodal Epstein-Barr virus- (EBV-) associated classic Hodgkin’s lymphoma (cHL), and peripheral T cell lymphoma afer treatment of nodal T cell lymphoma thirty years prior [16]. Te case that we present is exceptionally unique in the fact that it is the only report of three simultaneous hematopathologic neoplasms diagnosed in a patient with no previous exposure to chemotherapy or radiation. 2. Case Report Te patient, 77-year-old Israeli born male, nonsmoker with no known toxic exposures, was admitted initially for hip discomfort and difculty in ambulating. Upon initial pre- sentation, the patient’s labs were as follows: white blood cell count, 6.2, hemoglobin, 8.7, hematocrit, 25.6, an MCV, Hindawi Publishing Corporation Case Reports in Hematology Volume 2014, Article ID 738428, 6 pages http://dx.doi.org/10.1155/2014/738428