Rare Pedal Manifestation of Diffuse Multiple Myeloma Lesions

Rare Distribution of Sclerotic Bony Lesions in Multiple Myeloma: A Case Report

ABSTRACT

A 66-year-old man was referred to our hospital due to a newly discovered left chest wall mass, which was diagnosed as plasmacytoma on biopsy. The patient underwent 18F-FDG PET/CT scanning before treatment. PET imaging revealed intense FDG signal in osseous lesions, and the CT showed most of the lesions were osteoblastic. The osseous lesions were predominantly localized to the humerus, femur, tibia, and phalanx of toe.

Plasma Cell Dyscrasia of the Calcaneus: A Rare and Unusual Case Presentation

A rare and unusual case of plasma cell dyscrasia of the calcaneus is presented. Clinically, the patient had a draining and painful ulcer that was treated with appropriate antibiotics and wound care but failed to show any signs of healing. Radiographic images showed cystic changes of the calcaneus in the vicinity of the ulcer. Blood work was negative for bone and soft-tissue infection, but uric acid and alkaline phosphatase levels were elevated. Nuclear bone scan showed increased uptake in the calcaneus suggestive of osteomyelitis. One possible differential diagnosis was an intraosseous gouty tophus deposit. Not convinced that this was either a bone infection or gout, the author performed a bone biopsy. Pathologic evaluation indicated plasma cell dyscrasia. Continued wound care healed the ulcer completely, with resolution of pain of his heel. Oncology/hematology was consulted, and 16 months after biopsy, he remains asymptomatic.