Delayed diagnosis of multiple myeloma in a young patient: a call for vigilance in diagnosis

Multiple myeloma is a rare haematologic malignancy, representing about 1-2% of all cancers and 17% of haematologic malignancies in the US, predominantly affecting older adults and more common in African Americans (AAs) and men. Light-chain multiple myeloma, a subtype accounting for 15% of multiple myeloma cases, often has a more aggressive clinical course. This case report discusses a rare case of an AA female in her early 30s, diagnosed with light-chain multiple myeloma following a pathological rib fracture. Initial symptoms were atypical, and diagnosis was delayed due to her young age and lack of common multiple myeloma signs, such as anaemia and hypercalcaemia. Treatment included induction chemotherapy and autologous stem cell transplant, leading to complete remission. This case underscores the need for heightened clinical suspicion and thorough investigation in young patients presenting with unexplained bone lesions, highlighting the diverse presentations and challenges in diagnosing multiple myeloma in younger populations.