Multiple myeloma presenting with hepatosplenomegaly

Multiple myeloma, a clonal plasma cell disorder, commonly affects adults above 50 years age and accounts for about 10% of all hematological malignancies. Anemia, bone pains, renal failure are the most common symptoms at presentation. Though extra-medullary extra-osseous disease is well known in the course of the disease, initial presentation with extramedullary disease alone is rare. Such presentation may represent poor biology of the disease and/or advanced stage. Early diagnosis and treatment may improve outcomes. We herewith report the case of a 43 year old lady who presented with hepatosplenomegaly, without any classical manifestations of multiple myeloma and discuss the relevant literature.