Far and Few Between: Early Onset Multiple Myeloma in a 26-Year-Old Female

Abstract

Multiple myeloma (MM), a common hematologic malignancy, is predominantly a disease of old age with a median age at diagnosis hovering around 70 years. Medical literature remains largely bereft of reports of the ailment in young female patients. We chronicle the case of a 26-yearold female patient who presented with a history of fever, weight loss, constipation, frequent infections, and back and chest pain. Laboratory workup divulged underlying anemia, renal impairment, increased calcium, and significant urinary proteins, insinuating a diagnosis of MM. Subsequent bone marrow examination confirmed a diagnosis of MM. Following treatment with a concoction of dexamethasone, cyclophosphamide and bortezomib, the patient improved rapidly, and her clinical symptoms abated. This article further accentuates the need for physicians to be cognizant of the possibility of early-onset MM in unusually young patients.

The importance of bone marrow infiltration patterns in multiple myeloma seen on magnetic resonance imaging—Case report and imaging perspective

“…Modern imaging methods like MRI detect discrete marrow infiltration patterns before lytic lesions are detected on computed tomography and sometimes before the onset of any symptoms. 10 …”

“…Modern imaging methods like MRI detect discrete marrow infiltration patterns before lytic lesions are detected on computed tomography and sometimes before the onset of any symptoms. 10 On MR imaging, five different patterns of bone marrow infiltration in multiple myeloma were described. These patterns include a normal-appearing marrow, focal infiltration, diffuse infiltration, and "salt-and-pepper"; the fifth pattern is a combination of focal and diffuse infiltration 11,12 (Figure 3).…”