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Multiple myeloma presenting with widespread osteosclerotic lesions
Denis Mulleman1, Cédric Gaxatte, Gaëlle Guillerm
1Department of Rheumatology, Regional University Hospital, 59037 Lille, France. d.mulleman@chu-tours.fr
Joint Bone Spine
|February 11, 2004
Summary
Diffuse osteosclerosis is a rare finding in multiple myeloma, often mistaken for POEMS syndrome. This case highlights the importance of considering myeloma in patients with diffuse bone sclerosis.
Area of Science:
- Oncology
- Radiology
- Hematology
Background:
- Malignant monoclonal gammopathies, including multiple myeloma, typically present with lytic bone lesions.
- Sclerotic bone lesions are uncommon in these conditions, often associated with POEMS syndrome.
- Diffuse osteosclerosis is an exceptionally rare manifestation of multiple myeloma.
Observation:
- A 74-year-old woman presented with widespread, substantial osteosclerotic bone lesions.
- The patient had IgA-lambda myeloma but lacked other diagnostic criteria for POEMS syndrome.
- Rapid diagnosis of spinal cord compression was made due to the extensive osteosclerosis.
Findings:
- This case demonstrates a rare presentation of multiple myeloma with diffuse osteosclerosis.
- The imaging findings mimicked other conditions, underscoring diagnostic challenges.
- The patient's condition led to significant complications, including spinal cord compression.
Implications:
- Clinicians must consider multiple myeloma in the differential diagnosis for any pattern of bone sclerosis, including diffuse osteosclerosis.
- Recognizing unusual imaging features of myeloma is crucial for timely diagnosis and management.
- This case emphasizes the importance of a broad differential diagnosis in plasma cell neoplasms.