Keywords:
Musculoskeletal bone, Musculoskeletal spine, Musculoskeletal soft tissue, MR, CT, Ultrasound, Diagnostic procedure, Staging, Metastases
Authors:
I. Macleod, S. Aggarwal, J. Thomas, A. Abu Hassan, R. E. Ibrahem Adam; Nottingham/UK
DOI:
10.1594/essr2018/P-0119
Background
Myeloma is a disease that commonly requires input from musculoskeletal radiologists.
We are usually familiar with the vertebral findings in myeloma,
but confusion can arise when myeloma presents as solid tumours,
plasmacytoma,
outside of the skeleton – or when there is a coexistent malignancy.
Plasmacytoma can arise in any compartment and the mass effect and impact on local tissues can frequently be the presenting complaint.
We review several cases of atypical presentations of plasmacytoma,
including intradural and epidural deposits,
intramuscular and subcutaneous tumours (including bilateral breast deposit) ; from this,
we stress the need for comprehensive assessment of these patients to optimise management.
We also present images of myeloma in the presence of renal tumour.
In this situation,
it is not always clear from which tumour metastases have arisen.
We use these images to demonstrate findings that support a diagnosis of myeloma deposits over renal metastases,
which can aid timely patient management.