Osteosclerosing myeloma

Case contributed by Craig Hacking


Follow up.

Patient Data

Age: 80 years
Gender: Female

Severe generalized sclerosis of the entire spine.

Satisfactory alignment of the thoracic spine. Hypodensity within the T1 vertebral body has slightly increased in size. There appears to be soft tissue density adjacent to the left T8/9 and T9/10 neural foramina with possible extension into the spinal canal. Multiple bilateral paraspinal masses overall stable.

Multiple hypodense lesions within the lumbosacral spine which is most prominent in the L3 vertebral body appear to be stable when compared to prior imaging. Difficult to assess if there is any soft tissue density within the spinal canal. There does not appear to be any significant paraspinal soft tissue masses.

There is disease progression within the left side of the sacrum with mass extending into the left gluteal region. The mass extends to the posterior aspect of the left sacroiliac joint. There is no extension into the sacral foramina.

Left para-aortic lymph node at L2 measures 12 mm in short axis diameter. Hiatus hernia noted.


Disease progression of the bony and soft tissue involvement from multiple myeloma. Possible extension of the mass into the thoracic spinal canal. Cauda equina compression cannot be adequately assessed on CT and if there is a clinical concern, MRI recommended.

Case Discussion

MRI showed multiple levels of cord and cauda equina compression (images not available). The patient had a long history of multiple myeloma, diagnosed several years ago with bone marrow aspirate.

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