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MGUS bone.
Osamu Imataki1, Makiko Uemura1
1Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Oxford Medical Case Reports
|November 28, 2019
Summary
Monoclonal gammopathy of undetermined significance (MGUS) can present with bone lesions despite normal bone metabolism tests. This suggests osteolytic bone disease may precede multiple myeloma.
Area of Science:
- Orthopedics
- Oncology
- Pathology
Background:
- A 65-year-old man with severe cervical ossification of the posterior longitudinal ligament was evaluated.
- Incidental finding of a massive osteolytic pelvic lesion during preoperative assessment.
Observation:
- Standard bone health screenings, including bone mineral density, osteoporosis biomarkers, bone scintigraphy, and 18F-fluorodeoxyglucose-positron emission tomography, were unremarkable.
- Bone marrow aspiration showed a slight increase in plasmacytes (3.8%).
Findings:
- The patient was diagnosed with monoclonal gammopathy of undetermined significance (MGUS).
- The presence of osteolytic bone lesions associated with MGUS, without metabolic bone abnormalities, was noted.
Implications:
- Architectural osteolytic bone disease may be an early manifestation of MGUS.
- This presentation could indicate a precursor stage to multiple myeloma.
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