Osteosclerosing multiple myeloma: A case highlighting critical value of image findings for the diagnosis

Osteosclerosing myeloma is a specific form of multiple myeloma. We present a case of a 63-year-old woman who was found to have anemia during her medical checkup. Her blood tests suggested multiple myeloma, but she had diffuse osteosclerotic changes mainly in the axial skeleton, such as osteoblastic bone metastasis. On the other hand, the bone scintigraphy and FDG-PET showed almost normal. Osteosclerosing myeloma is similar to osteoblastic bone metastases and POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome, but is characterized by a lack of response to nuclear medicine testing, reflecting very low activity. This case highlights the critical value of the image findings of osteosclerosis myeloma and promotes awareness of this highly unusual but unique form of the disease.