In this patient, bone marrow aspiration analysis was suggestive of multiple myeloma. Urine analysis was positive for Bence Jones protein.

Multiple myeloma should be differentiated from lytic metastases.

Lytic metastases are less likely to be discrete and uniform in size and do not create the same kind of discrete endosteal scalloping as multiple myeloma.

Metastases favor pedicle and posterior elements, and are positive on bone scan.

Mandible is rarely involved in metastases. 

Numerous characteristic lytic lesions in the clavicle are far more likely to be due to myeloma than metastasis.