Multiple myeloma

Case contributed by Dr M Osama Yonso
Modality: X-ray

Bony lytic lesions in skull are well defined, as if 'punched out'.

Case Discussion

Multiple myeloma is the most common primary malignant bone neoplasm in adults, and results in a wide range of radiographic abnormalities.

Multiple myeloma may simulate carcinomatosis radiologically,but is distinguishable from it by the absence of a known primary lesion and presence of Bence Jones proteibs in the urine,an abnormal serum electrophoretic pattern with excess of gamma globulin,and myeloma cells in a marrow biopsy sample.

Four main patterns are recognised:

  • disseminated form: multiple defined lesions: predominantly affecting the axial skeleton
  • disseminated form: diffuse skeletal osteopaenia
  • solitary plasmacytoma: single large/expansile lesion most commonly in a vertebral body or in the pelvis
  • osteosclerosing myeloma
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Case Information

rID: 17706
Case created: 6th May 2012
Last edited: 19th Jan 2016
Tag: skull
Inclusion in quiz mode: Included

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