Insisting Pain on the Mid-scapular Line

Neoplastic diseases are commonly paired with a wide range of non-specific clinical symptoms. Even the most alarming complaints pose a low positive predictive value making diagnosis of an underlying malignancy a major detective challenge for the primary care physician. Therefore, although cancer may be suspected for not be missed, as management failure within primary care, diagnosis usually occurs in the context of a secondary care setting. Here we present a case of a patient seeking medical advice from his general practitioner due to a two-week history of back thoracic pain. Following investigations, the patient was early diagnosed with myeloma. Current notion of target-driven laboratory tests utility that may be used as possible clues for the detection of multiple myeloma at a primary care level is also discussed to enhance capacity.