Multiple myeloma

Case contributed by Dr M Osama Yonso

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
Published: 6th May 2012
Last edited: 19th Jan 2016
Tag: skull
Inclusion in quiz mode: Included

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