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Case report
peer-reviewed

Concurrent Multiple Myeloma and Metastatic Osteosarcoma: A Case Report and Literature Review



Abstract

Multiple myeloma (MM) and osteosarcoma (OS) are two common bone malignancies, however, the simultaneous occurrence of both primary bone tumors in the same patient has not been reported in the United States to date. We present a unique case in which both malignancies present concurrently in a 72-year-old man. Results of spinal magnetic resonance imaging (MRI), radiographic skeletal survey, and hematological workup established the initial diagnosis of MM. Approximately three months later, the patient was admitted with severe right hip pain and shortness of breath and was evaluated with computed tomography (CT) of the right hip, abdomen, pelvis, and chest, revealing an osseous mass with a “sunburst” pattern in the right hip, and several calcified nodules in the lungs. Subsequent wedge resection and histological evaluation of the lung nodules confirmed the diagnosis of metastatic OS to the lungs, with a presumptive diagnosis of primary OS of the right hip. The clinical findings and imaging characteristics in this case are presented. Two similar cases found in the literature are also briefly discussed. The findings of this case report suggest that, in rare instances, MM patients with sclerotic bone findings may have a concurrent diagnosis of OS.



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Case report
peer-reviewed

Concurrent Multiple Myeloma and Metastatic Osteosarcoma: A Case Report and Literature Review


Author Information

Ashley Ramirez

Diagnostic Radiology, Florida Hospital-Orlando

Vincent Grekoski

Diagnostic Radiology, Florida Hospital-Orlando

Michael Valente

Diagnostic Radiology, Florida Hospital-Orlando

Fiona Tissavirasingham

Diagnostic Radiology, Florida Hospital-Orlando

Alessandra Fahey

Diagnostic Radiology, Florida Hospital

Nicole Guevara

Diagnostic Radiology, Florida Hospital-Orlando

John W. Stelzer

College of Medicine, University of Central Florida

M. Joe Ma

Pathology, Florida Hospital Orlando

Anatomic Pathology/neuropathology, Florida Hospital-Orlando

Jeremy Burt Corresponding Author

Diagnostic Radiology, Florida Hospital-Orlando


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. This case report was approved by the Florida Hosptial IRB and Office of Research Administration. Conflicts of interest: The authors have declared that no conflicts of interest exist.

Acknowledgements

Special thanks to Carole Coyne, Kairsten Turner, and Natalie Reyes for assistance with this case report.


Case report
peer-reviewed

Concurrent Multiple Myeloma and Metastatic Osteosarcoma: A Case Report and Literature Review


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Case report
peer-reviewed

Concurrent Multiple Myeloma and Metastatic Osteosarcoma: A Case Report and Literature Review

  • Author Information
    Ashley Ramirez

    Diagnostic Radiology, Florida Hospital-Orlando

    Vincent Grekoski

    Diagnostic Radiology, Florida Hospital-Orlando

    Michael Valente

    Diagnostic Radiology, Florida Hospital-Orlando

    Fiona Tissavirasingham

    Diagnostic Radiology, Florida Hospital-Orlando

    Alessandra Fahey

    Diagnostic Radiology, Florida Hospital

    Nicole Guevara

    Diagnostic Radiology, Florida Hospital-Orlando

    John W. Stelzer

    College of Medicine, University of Central Florida

    M. Joe Ma

    Pathology, Florida Hospital Orlando

    Anatomic Pathology/neuropathology, Florida Hospital-Orlando

    Jeremy Burt Corresponding Author

    Diagnostic Radiology, Florida Hospital-Orlando


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. This case report was approved by the Florida Hosptial IRB and Office of Research Administration. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements

    Special thanks to Carole Coyne, Kairsten Turner, and Natalie Reyes for assistance with this case report.


    Article Information

    Published: August 31, 2017

    DOI

    10.7759/cureus.1634

    Cite this article as:

    Ramirez A, Grekoski V, Valente M, et al. (August 31, 2017) Concurrent Multiple Myeloma and Metastatic Osteosarcoma: A Case Report and Literature Review. Cureus 9(8): e1634. doi:10.7759/cureus.1634

    Publication history

    Received by Cureus: July 04, 2017
    Peer review began: August 01, 2017
    Peer review concluded: August 16, 2017
    Published: August 31, 2017

    Copyright

    © Copyright 2017
    Ramirez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Multiple myeloma (MM) and osteosarcoma (OS) are two common bone malignancies, however, the simultaneous occurrence of both primary bone tumors in the same patient has not been reported in the United States to date. We present a unique case in which both malignancies present concurrently in a 72-year-old man. Results of spinal magnetic resonance imaging (MRI), radiographic skeletal survey, and hematological workup established the initial diagnosis of MM. Approximately three months later, the patient was admitted with severe right hip pain and shortness of breath and was evaluated with computed tomography (CT) of the right hip, abdomen, pelvis, and chest, revealing an osseous mass with a “sunburst” pattern in the right hip, and several calcified nodules in the lungs. Subsequent wedge resection and histological evaluation of the lung nodules confirmed the diagnosis of metastatic OS to the lungs, with a presumptive diagnosis of primary OS of the right hip. The clinical findings and imaging characteristics in this case are presented. Two similar cases found in the literature are also briefly discussed. The findings of this case report suggest that, in rare instances, MM patients with sclerotic bone findings may have a concurrent diagnosis of OS.



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Create a free account to continue reading this article.

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Ashley Ramirez

Diagnostic Radiology, Florida Hospital-Orlando

Vincent Grekoski

Diagnostic Radiology, Florida Hospital-Orlando

Michael Valente

Diagnostic Radiology, Florida Hospital-Orlando

Fiona Tissavirasingham

Diagnostic Radiology, Florida Hospital-Orlando

Alessandra Fahey

Diagnostic Radiology, Florida Hospital

Nicole Guevara

Diagnostic Radiology, Florida Hospital-Orlando

John W. Stelzer, Medical Student

College of Medicine, University of Central Florida

M. Joe Ma

Pathology, Florida Hospital Orlando

Jeremy Burt

Diagnostic Radiology, Florida Hospital-Orlando

For correspondence:
jeremy.burt.md@flhosp.org

Ashley Ramirez

Diagnostic Radiology, Florida Hospital-Orlando

Vincent Grekoski

Diagnostic Radiology, Florida Hospital-Orlando

Michael Valente

Diagnostic Radiology, Florida Hospital-Orlando

Fiona Tissavirasingham

Diagnostic Radiology, Florida Hospital-Orlando

Alessandra Fahey

Diagnostic Radiology, Florida Hospital

Nicole Guevara

Diagnostic Radiology, Florida Hospital-Orlando

John W. Stelzer, Medical Student

College of Medicine, University of Central Florida

M. Joe Ma

Pathology, Florida Hospital Orlando

Jeremy Burt

Diagnostic Radiology, Florida Hospital-Orlando

For correspondence:
jeremy.burt.md@flhosp.org