Spontaneous sternal fracture due to multiple myeloma requiring extensive surgical repair

Abstract

Spontaneous sternal fracture is a well-known complication of multiple myeloma due to osteolytic bone lesions. The possibility of a multiple myeloma should be thoroughly investigated in patients presenting with a spontaneous sternal fracture. This work up should go beyond protein electrophoresis alone as a monoclonal paraprotein is not always present. In some cases, the myeloma plasma cell clone produces only the free light chain (κ or λ) or may even be non-secretory. The underlying plasma cell dyscrasia is treated with chemotherapy and, if needed, local radiotherapy. However, for patients with a fracture causing persistent pain and physical discomfort, internal fixation may be additionally required. We present a case of a patient who presented with a displaced pathological sternal fracture. She was treated with chemotherapy, radiotherapy and an open reduction and internal fixation with a Locking Compression Plate (LCP). This technique offers a feasible option for rigid fixation of pathological fractures.

Backache could be an indication of multiple myeloma: An unusual case report

“…Again the past history of road side accident in the current case report is not a usual finding because the development of MM after the history of trauma has not been documented. Researchers and clinician has suggested that with the progression of MM the patient suffers multiple fractures due to lytic bone lesions 9,10 . In this case, the suspicion of MM was raised by MRI findings.…”