Multiple Myeloma Mimicking Bone Metastasis: The Contribution of Biochemistry Laboratory to Differential Diagnosis<br /> <div> <br /> </div>

Abstract

Breast carcinoma is a tumor that tends to metastasize to various organs. The hasty diagnosis of metastasis in patients treated for breast carcinoma who report symptoms for another malignant tumor, may be the cause of diagnostic and therapeutic delay. We report the case of a patient with breast ductal carcinoma, having completed her therapeutic protocol, she came in 3 years later with severe bone pain, epistaxis and headache in a context of asthenia and anorexia, suggesting a relapse of her breast cancer with bone metastasis. On clinical examination, the patient presented with cutaneous and mucosal pallor. She had no other signs of secondary localization, the performance of electrophoresis and immunofixation of serum proteins, led to a diagnosis of multiple myeloma. This observation highlights the diagnostic difficulty that can arise in patients treated for breast carcinoma who present with a malignant hemopathy mimicking a metastasis of the initial cancer, or other cases where the multiple myeloma is synchronous with other malignancies. This clinical similarity may delay treatment and worsen the patient's condition. This situation can be avoided by the simple performance of protein electrophoresis, which is a relevant method of diagnosis and follow-up of monoclonal gammopathies thanks to the efficient separation of serum proteins and quantification of monoclonal peaks.