Case report 621. Multiple myeloma (IgD) in a 28-year-old woman

A 28-year-old woman with IgD myeloma was described. The patient presented with pain in the anterior wall of the chest, and tenderness over the ribs, thoracic spine, and right shoulder. A radionuclide bone scan showed increased uptake along the costochondral junctions, ribs, and shoulders, with the diffuse uptake in the costochondral junction being typical for costochondritis. Skeletal survey revealed small lucencies in the ribs, humeri, and shoulders, characteristic of MM. The patient's young age made the diagnosis of MM unlikely. The scintigraphic finding, typical of costochondritis, must be an extremely unusual pattern in MM since we were unable to find a similar case in the literature. It is speculated that MM may have been induced by chemical exposure.