Osteosclerosing myeloma

Last revised by Daniel J Bell on 10 Jul 2023

Osteosclerosing (or osteosclerotic) myeloma is an uncommon form of multiple myeloma. It may manifest as multiple sclerotic lesions or areas of diffuse osteosclerosis 3. It once was considered in the same spectrum of plasma cell dyscrasias with polyneuropathy as POEMS syndrome but is now considered a separate entity.

Compared with multiple myeloma, it is seen in younger patients and has a more indolent course.

Patients typically present with peripheral neuropathy. Bone pain is not a common feature.

Laboratory findings include:

There is usually a low percentage of plasma cells of bone marrow aspirate, compared to classical multiple myeloma where there is a high percentage. A small monoclonal protein is present which is usually IgA or IgG 3.

The bones contain multiple sclerotic lesions but there may be mixed or purely lytic lesions as well. Diffuse osteosclerosis is rare.

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