CASE REPORT   

Il Giornale Italiano di Radiologia Medica 2019 Maggio-Giugno;6(3):238-43

DOI: 10.23736/S2283-8376.19.00170-0

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

A rare case of multiple myeloma with extramedullary localizations: diagnosis and follow-up by computed tomography

Anna ROTUNDO ✉, Valentina SETTINO, Domenico LAGANÀ

Division of Radiology, Department of Clinical and Experimental Medicine, Mater Domini University Hospital, Catanzaro, Italy

Multiple myeloma is a proliferative disorder of plasma cells. The median age at diagnosis is 60 years old with bone marrow localization and possible involvement of surrounding tissues. Extra-medullary localizations are quite rare: in this case head, neck, gastrointestinal system, pararenal and retroperitoneal spaces, genito-urinary apparatus and subcutaneous tissues are possible target sites. The case of a 47-year-old male, affected by this disease, is described in this article. This patient sought medical care for hyperpyrexia, without a remarkable history. Chest X-ray showed a consolidation of the lower lobe of the right lung and decreased bone density in some vertebrae and ribs, so further ascertainments were necessary. CT demonstrated an enlargement of the ninth rib, on which a biopsy was performed. Biopsy result suggested a plasmacytoma. This result combined with laboratory exams and other ascertainments led to a diagnosis of multiple myeloma. After only a few months nodular solid lesions, with irregular boarders and inhomogeneous enhancement by contrast enhanced CT, developed in multiple sites. These lesions represented extramedullary localizations of multiple myeloma. Follow-up showed a rapidly worsening clinical picture and poor response to treatment.

KEY WORDS: Multiple myeloma; Bone marrow; tomography, X-ray computed