Author/Authors :
Low، Soo Fin نويسنده Department of Radiology, Malaysia Medical Center,
University Kebangsaan, Kuala Lumpur, Malaysia , , Mohd Tap، Nor Hanani نويسنده Department of Radiology, Malaysia Medical Center,
University Kebangsaan, Kuala Lumpur, Malaysia , , Kew، Thean Yean نويسنده Department of Radiology, Malaysia Medical Center,
University Kebangsaan, Kuala Lumpur, Malaysia , , Ngiu، Chai Soon نويسنده Department of Medicine, Malaysia Medical Center,
University Kebangsaan, Kuala Lumpur, Malaysia , , Sridharan، Radhika نويسنده Department of Radiology, Malaysia Medical Center,
University Kebangsaan, Kuala Lumpur, Malaysia ,
Abstract :
Multiple myeloma (MM) is characterized by progressive proliferation
of malignant plasma cells, usually initiating in the bone marrow. MM can
affect any organ; a total of 7 - 18% of patients with MM demonstrate
extramedullary involvement at diagnosis. Non-secretory multiple myeloma
(NSMM) is a rare variant that accounts for 1 - 5% of all cases of
multiple myeloma. The disease is characterized by the absence of
monoclonal gammopathy in serum and urine electrophoresis. Our case
report highlights the diagnostic challenge of a case of NSMM with
extensive extramedullary involvement in a young female patient who
initially presented with right shoulder pain and bilateral breasts
lumps. Skeletal survey showed multiple lytic bony lesions. The initial
diagnosis was primary breast carcinoma with osseous metastases. No
monoclonal gammopathy was found in the serum or urine electrophoresis.
Bone marrow and breast biopsies revealed marked plasmacytosis. The
diagnosis was delayed for a month in view of the lack of clinical
suspicion of multiple myeloma in a young patient and scant biochemical
expression of non-secretory type of multiple myeloma.
