Unusual Presentations of Multiple Myeloma: Case Report And Review With Focus On Therapeutic And Psychological Aspects

No Thumbnail Available



Journal Title

Journal ISSN

Volume Title


Internet Scientific Publications


Background: Unusual presentations of multiple myeloma which poses a diagnostic dilemma. Objective: To report unusual presentations of multiple myeloma and highlight how early detection of these unusual features will encourage early investigation, diagnosis and appropriate management and consequently better prognosis of this difficult disease of multiple myeloma. Patients and Methods: Two cases of multiple myeloma initially managed at Ela Memorial Medical Centre, Ilorin, were presented. The clinical features, management and outcome were extracted from the case notes. After operations on the patients the histological specimens were sent to University of Ilorin Teaching Hospital (U.I.T.H.). The patients were later transferred to UITH for further management. Results: The first case report presented with multiple swellings on the right shoulder, left chest wall, and back and weight loss. X-ray showed fracture of the left clavicle. The erythrocyte sedimentation rate was normal. Bence-Jones Protein was positive and histological report and Bone Marrow aspiration cytology confirmed multiple myeloma. The second case report presented with inability to use the right upper limb and later developed severe pain on the right shoulder and weakness of the right upper limb. X-ray showed fracture of the upper third of the right humerus. Erythrocyte sedimentation rate was very high and Bence-Jones protein was negative. Histological report was suggestive of multiple myeloma whilst bone marrow aspiration confirmed multiple myeloma. The first case was lost to follow up whilst the second case died during chemotherapy. Conclusion: Presence of multiple swellings on the body and pathological fractures should suggest that such patients should be investigated for multiple myeloma. Failure to start the investigations will lead to delayed diagnosis, delayed management and very poor prognosis.



Unusual Presentations, Multiple myeloma, Review, Therapeutic, Psychological, Aspects


Agaja, S., Babalola, O., Olawumi, H., Babatunde, A. (2006). Unusual Presentations of Multiple Myeloma: Case Report And Review With Focus On Therapeutic And Psychological Aspects. The Internet Journal of Orthopedic Surgery. 6(2):1-6..