Multiple Myeloma Associated with Osteosclerotic Bone Lesion Presenting as Chest Wall Masses

Abstract

Multiple myeloma is a plasma cell neoplasm with osteolytic bone lesion. Osteoblastic bone lesion is rare, and patients frequently present with anemia, renal insufficiency, bone pain and impaired immunity. This report describes the case of a 71-year-old man, who presented with bilateral chest wall masses, but was otherwise asymptomatic. Multiple myeloma with involvement of the ribs was diagnosed via echo-guided biopsy and bone marrow aspiration. The CT showed peripheral and scattered calcification of the mass. The pathology also displayed osteosclerosis manifesting as excess bone deposition on existing bone surfaces, a rare presentation of multiple myeloma with osteoblastic reaction, that should be borne in mind in the presence of diffuse or discrete bone sclerosis. Treatment with conventional chemotherapy rarely achieves complete remission. Autologous stem cell transplantation offers a potential cure. Although rare, multiple myeloma should be included in the differential diagnosis of osteosclerotic bone lesions.