Parathyroid adenoma and light chain myeloma

An elderly patient with simultaneous hyperparathyroidism and light chain myeloma is described. The patient presented with hypercalcemia, bone pain, pathologic fractures, and cystic and lytic bone lesions. The problems of diagnosis and management are discussed. It is recommended that elderly patients with hypercalcemia and bone lesions should have not only diagnostic studies for hyperparathyroidism but also serum and urine immunoelectrophoresis to detect multiple myeloma or plasma cell neoplastic variants. Surgery is indicated for the hyperparathyroidism. Chemotherapy and localized radiotherapy usually control the myelomatous disease.