Hypervascular presentation of multiple myeloma involving the skull, demonstrated on encephaloscintigraphy

We present two cases of myelomatous involvement of the skull. Correlative studies with routine radiography, angiography, and encephaloscintigraphy were performed. The areas of involvement of the skull were confirmed as autopsy. A mixed pattern of photon-deficient and photon-abundant lesions was noted. The clinician should be aware of such mixed patterns.